Baseline Testing
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Introducing to Canada, the future of concussion baseline testing. We provide testing for athletes pre and post injury. The data obtained from baseline testing is important to have as it can be used as a benchmark for comparison should an athlete sustain a whiplash or mild to moderate concussion, or an orthopedic injury.
TRAZER allows us to offer a unique baseline test that assesses the integration of vision, mind and body. With the use of simulation and high-powered optics, TRAZER’s patented technology uniquely replicates field/life conditions, while objectively quantifying whole-body, dynamic reaction times. TRAZER overloads the brain with multiple demands, while simultaneously challenging the cardio respiratory and orthopedic systems - to both test and train the patient or athlete’s Acceleration (ability to start), Deceleration (ability to stop), Gait Speed, Vertical Leap, Heart Rate, and more. TRAZER is changing the game by providing objective data and analytics that allow a clinician or coach to more accurately assess, rehabilitate, train, and safely determine if an athlete is ready to return to play.
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The Incorporation of Objective Baseline Testing as a Necessary Component of the Safe-Return-to-Play Decision Making Process
I share in the commitment to provide the safest environment for children participating in sport, and to reduce, where possible, the risk of injury. In the case of concussion. There has been great advancement in awareness and the immediate removal of injured parties from their activity. However, I feel there is now an absolute necessity to address the safe-return-to-play process.
The question is: when is an injured athlete, whether they sustained a head-injury/concussion/ or orthopaedic injury, actually ready to safely return to their respective sport? In a perfect world, we would have a snapshot of their performance capabilities prior to their injury that we could reference, and as they recover, we could monitor their progress or regression. When their performance had improved to the level of their pre-injury performance, we could then begin to consider their return to play.
Baseline testing is the standard in many industries worldwide and the concept is fundamentally sound. Hence, all the initial excitement to try to incorporate it into the concussion model. However, the technology was not available at that time and innovators were trying to retrofit tests that were designed for other purposes and apply them to variables of a concussion with little effectiveness or reliability. Therefore in 2012, it was the correct decision not to put too much emphasis on the baseline testing as it was proposed, constructed and being applied.
Over the past seven years, with the aid of technological advancements, that has changed.
Trazer, a sport performance testing company for the last 20 years, addressed the problem as their researchers devised a well thought out, structured program using the latest technology currently available in 2019. Their research has provided us with meaningful measurements that give us insight into one’s performance. Following injury, they have identified specific data trends and patterns that can be used to evaluate one’s status and fitness to return.
Mainly, the reaction time to random stimuli; the ability to stop on a dime; and the lateral shuffle test that can provide us with some of an athlete’s relevant and objective measurement metrics. These metrics can further provide valuable insights for the decision makers as to the athlete’s ability to perform. The data is acquired in an environment that simulates the demands of their performance requirements in the real world.
No definitive decision should be made in a doctor’s office as to an athlete’s fitness to return to play without any objective performance data under duress to support it. Consider the heart-stress test that incorporates a treadmill to create physical exertion to uncover underlying irregularities/pathologies that would otherwise go unnoticed at rest. Similarly, in our application, taxing the brain or orthopaedic injury under demand/duress could uncover cognitive or orthopaedic insufficiencies that are only elicited under stress. These relevant marker’s, tendencies and insights could help gauge one’s fitness to return. For example, my car overheats when I drive it on the highway for 15 minutes at 60 miles per hour, but when I take it to my mechanic, he starts it up and it runs fine while at rest in his garage. That’s a dangerous paradigm to promote.
Furthermore, when we consider more recent definitions of concussion referring to an energy crisis at the cellular level of the mitochondria and an ATP insufficiency, it becomes essential to incorporate active testing into the evaluation process.
If we’re going to put the athlete in the safest position to return, we must provide the decision makers with more information to ensure a better and more accurate decision-making processes. As in any research project, self-reporting of a subject who gets a reward for choosing one answer over another is considered a biased test. Bias tests are not associated with a lot of validity in the research world. We cannot allow the injured athlete to dictate verbally or proclaim their readiness to return without substantiating their claim based on supportive objective performance data. This is especially significant when you consider that there can be a 25-30 percent performance response time deficit still present after the self reported symptoms have subsided.
The Trazer can act as a standardized test to aid in the decision-making process and has 6-stage rehabilitation protocols which were designed by the Cleveland Clinic. The athlete’s performance capabilities are recorded on each subsequent test, and the software automatically provides comparative data evaluations, which are provided via printout, cloud-based website or PDF, to the decision makers, and they can then clearly see via relevant data, the individuals performance improvements or degradations. They then have a target to aim for as they know what the athlete’s capabilities are when healthy.
This, minimally, can provide an additional information to aid in a better more accurate decision- making process and in conjunction with how the Doctor or other decision makers perform their own individual assessment on criteria they deem relevant.
The TRAZER is the first credible technological advancement that can be incorporated into the decision- making process of head-injury/concussion, and orthopaedic injuries, and safely screen for those who would otherwise prematurely be put in harms way.
If we truly want to be the leaders in protecting our athlete’s, we must equip our decision makers with relevant objective data where possible and get onboard with other divisions of health and safety which lean heavily on technology that contribute valuable data to help solve our problems. What disturbs me terribly is the regression of going back to protocols with subjective reporting that I employed some 28 years ago as a trainer in the G.T.H.L. and witnessed first- hand its ineffectiveness and unreliability.
The technology devised by TRAZER’s engineers (or some derivative of that technology) will become an integral component of how concussions are evaluated and shape the safe return to play process.
I would like to share a quote I read along the way that I feel relevant:
“If you are not measuring your guessing” and with the magnitude of the potential devastation that can accompany a concussion. Guessing is clearly not an option.
Please find enclosed some research articles. more are available on request. For more information on Trazer please contact me at 905- 882- 4476, 416 – 704 – 1437, or spanpt.com
Dr. Stuart Greenspan D.C.
Read React Respond
Making A Difference Where It Is Desperately Needed
The Incorporation of Objective Baseline Testing as a Necessary Component of the Safe-Return-to-Play Decision Making Process
Awareness of the dangers of concussion in sport and the importance of dealing with it properly has increased in recent years. Immediate removal of anyone with a head-related injury from their respective activity is essential in protecting them against further potential injury. New regulations are putting return-to-play decision-making squarely in the lap of the medical doctor without necessarily providing them with standardized, objective and reliable procedures for how to do so. Often the Doctor has little or inadequate information beyond the self –reporting of the patient presenting to their office but is faced with making a decision that could potentially place the patient in harm’s way. Statistically, it is common for there to be a 25-30 percent response time deficit still present after the reported symptoms have subsided.
Evaluation processes and treatment methods are constantly evolving as research advances. To date, attempts to determine when a safe return-to-play status has been reached have been marked by contributions from a collection of available methods such as Neurocognitive testing, imPACT, SCAT, accelerometers, GPS tracking systems, elevating heart-rate, eye movement patterns (VOMS), impact meters and looking for the recurrence of symptoms. These all seek to extrapolate a picture of one’s overall fitness from isolated or limited aspects of one’s symptoms or performance. Clinically, none of these methods have proven to be reliable predictors of safe return-to-activity.
What has been proven clinically is the link between head injury and delayed or impaired reaction time and the ability to decelerate (stop). The link between concussion and orthopaedic injury, such as risk to the ankle and knees with impaired cognitive function or the risk of concussion injury post orthopaedic injury, has been proven as well.
Furthermore, functional movement imbalances-that is asymmetries in left/right movement (shuffle test) have been found to be an indicator of lingering concussions and/orthopaedic injury.
Thus, no participant should ever return to their respective activity until they are able to read, respond and, react to visual cues at full speed, under exertion, as well as they could before their injury.
Here’s the problem: None of the commonly used testing and screening methods accurately test and compare pre- and post-injury performance. Enter TRAZER!
TRAZER is a neuromechanical device – which overloads the brain with multiple tasks, while the body is in constant motion and concurrently works to elevate the heart rate. TRAZER places demands upon the participant that resemble tasks that they are frequently required to perform throughout activity, thus making the results relevant in the real world.
It is believed that this synergy, requiring the subject to sense – process – and execute concurrently is what sets it apart.
TRAZER is a baseline testing device that uses computer simulation and high-powered optics to simultaneously and objectively measure one’s processing of cognitive, sensory and motor information. It includes a six stage progressive concussion management system that was specifically designed by the Cleveland clinic. TRAZER has been providing sports performance and rehabilitation data for healthcare providers for 20 years.
I first served, 27 years ago, as a trainer in the GTHL and subsequently as a head coach and trainer for many years. In my experience, systems that revolve around players subjectively deciding when they feel ready to return are doomed to fail, as many players may not translate their symptoms accurately and on occasion intentionally mislead the decision maker to expedite their return to play.
Span Performance Testing is proposing where technology has afforded us the ability to be more accurate, implementing baseline testing that exploit leading edge, well-researched technology.
TRAZER provides an objective universal standard screening test that can serve as an additional evaluation tool for both concussion and orthopaedic injury. TRAZER can be used for all sports and can monitor an individual’s progression or regression over time and assist in evaluating those claiming they are ready and fit to return. Computer generated comparative printouts following each test are available for decision-makers to evaluate. One must be able to perform on subsequent tests as they could before injury and prove that reaction time and other key performance parameters have healed to the point where protecting one-self in real time and space will be possible. The testing is performed in a safe environment and measures reaction time to random stimuli, in addition to acceleration, deceleration, speed, distance travelled and heart rate - all of which have relative and collective significance and can uncover and quantify cognitive and motor deficiencies.
The TRAZER is the most significant and up-to-date technological advancement (2019 most recent update) in objectively gauging one’s performance during recovery. Incorporating it into the decision-making process will help reduce stress on players, parents, coaches, volunteers, trainers and doctors. Because it compares the athlete’s movement metrics pre- and post-injury, it provides clearly defined targets to work towards.
Five years ago, I was a guest on City TV News advocating the importance of proper protocol implementation on matters such as this: (https://toronto.citynews.ca/2014/08/21/chiropractor-discusses-concussions-and-preventions/). I have been a guest on Breakfast Television, co-hosted a sports injury show on The Fan sports radio station and have appeared on concussion related web podcasts.
I have incorporated those proposed protocols that are currently being suggested for more than twenty-five years now, and can tell you that, objective testing is required to more accurately assess improvement at all stages of the recovery process.
There have been great strides made recently to increase the public’s concussion awareness and the necessity for immediate removal of participants from activity following head trauma. However, the potentially devastating effects of concussion and second impact syndrome have made it equally important to make progress in the safe return-to-play decision making process. We must act now to facilitate change and concentrate on incorporating superior diagnostics, better treatment and screening tests for the injured.
TRAZER provides benefits unavailable anywhere else:
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Designed to Protect the Injured Athlete;
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Objective, standardized and relevant data is managed via a secure, private web portal
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Data can be shared with Other Testing Facilities, healthcare providers, coaches, etc.
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Data has been validated against the Viacon MoCap System and is accurate
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Portable;
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Cost Effective;
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Interactive;
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An Administration Time-Saver;
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Fun, challenging and quick;
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The Most Advanced, Informative and Clinically Proven Testing Available.
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An invaluable component of the decision-making process going forward
We would like the opportunity to demonstrate the benefits of this product to you so you can see its value first hand. Please contact us at Span Performance Testing.
Let technology measure your performance capabilities and become part of the solution to providing safer return-to-play decisions.
READ REACT RESPOND
MEASURE WHAT MATTERS BEFORE YOU RETURN
Thank you,
Dr. Stuart Greenspan, DC