Students who take a nasty hit to the head during a sports game are usually willing to sit out the next few plays. They might want to sit out the next few games.
Current research at the University has found that the effects of a concussion often linger for much longer than most think – more than a month in many cases.
Physiology professor Li-Shan Chou began his research evaluating concussion patients’ walking mechanics and mental abilities in 2002, just two years after he arrived at the University. Chou found that young people who had suffered head injuries swayed side to side more when they walked, and subjects often faltered when trying to perform simple verbal tasks such as spelling a word backward while walking.
A normal person sways about four centimeters side to side while walking, Chou said. Many of his concussion patients swayed an additional centimeter, as much as a 25 percent increase.
Chou said he uses his background in biomechanics to analyze the small but significant increases in human movement with the help of equipment in the University’s Motion Analysis Lab in Gerlinger Annex.
“It’s very difficult for us to picture that visually, so you have to rely on this kind of system to be able to detect the difference,” Chou said. To help monitor subjects’ movement, patients are asked to wear electronic sensors that record movement in front of several cameras.
In general, Chou said, the occurrence of concussions is a widely underreported problem because people don’t take them seriously enough. He said about 300,000 sports-related concussions are reported in the United States each year, and an average of 900 of those will later result in death from complications.
Chou said the risk of more serious injury increases with each incident.
“If a person suffers their very first concussion, his or her chance to get a second concussion is about four times higher than people who do not have a previous concussion,” Chou said.
People with two concussions is eight times more likely to get hit to the head a third time than those who have never suffered their first.
Chou said he finds his subjects mainly on a voluntary basis and through his ties with the University Health Center. He said people too often ignore a head injury because they don’t know the effects, and many, especially football players, put themselves in danger too soon.
“Just think about – if a person cannot walk straight in a laboratory, and you place that person back in a very competitive and very aggressive sports field, what is going to happen?” Chou said. “Because of the deficit in his or her concentration, or body concentration, it’s very likely to result in another injury.”
Chou, along with the help of physiology student Robert Catena since the fall of 2003, has published about 10 peer-reviewed papers as part of his research, he said. One of his main goals is to educate students and athletes about the future risks associated with concussion patients.
“What we are doing here is try to prevent this injury from occurring again on the same individual, and also make the general public aware,” Chou said.
Catena agreed, and said the experience has been a valuable one.
“It’s been great,” he said. “Besides the fact that it’s something that I love to do, this research is pretty original.”
Chou said people likely aren’t aware of the dangers of concussions because little research has been done on the subject prior to his work. Subjects haven’t been monitored long enough, he said. In Chou’s studies, subjects are first evaluated within 48 hours of the initial injury, when the effects are most evident, then again after six days, 14 days and 28 days.
Chou is also approaching the issue from multiple fronts. In addition to his work on motion mechanics in the Motion Analysis Lab, he also collaborates with fellow physiology professor Paul van Donkelaar, who specializes in brain function, and has the benefit of observing brain activity with the large MRI machine available in the Lewis Center for Neuroimaging.
“It mixes the areas of neurophysiology and biomechanics,” said Department of Human Physiology head Gary Klug. “You’re able to devise a really unique model for evaluating these subjects that you wouldn’t normally get by using one approach.”
Klug added that the study fits well into the department’s emphasis on clinical and practical research.
Chou said the study is federally funded by the Centers for Disease Control and Prevention, and he plans to renew the grant and continue his work beyond just University subjects. Despite significant gains, he said, there is plenty more to discover in a relatively unexplored field.
“We don’t know what’s really going on inside our brain when your head is hit by something,” Chou said. “The brain is such a complicated organ.”
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