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Members of the Institutes Board of Directors and Advisory Council have continued to produce cutting edge research on the fronts of injury prevention and health care cost containment. It has been estimated that twelve million student athletes, aged 5-22, will seek health care, both in emergency rooms and in private physicians offices, for sports related injuries this year alone in the United States. It is our contention at the Institute that the vast majority of these injuries are completely preventable. Our current research endeavors at the Institute have focused on the sports of baseball, softball, soccer, and golf. Our most recent publication, which I have enclosed for your review, entitled: The Prevention of Commotio Cordis in Baseball: An evaluation of Chest Protectors. Was recently published in the Journal of Trauma. Dr. David Viano, Dr. Cynthia Bir, Angela Cheney, and Dr. Dave Janda were the co-authors of this analysis. As you are well aware, our research team as well as the GM Research Laboratories has been on the leading edge of the chest impact fatality scenario over the last ten years.

The most common scenario for student athletes sustaining a fatal event in sport is of a baseball impact to the chest. This scenario is called commotio cordis. It occurs when a ball or hockey puck impacts the chest at the precise phase of the heart cycle. If the impact occurs at this precise moment the heart can be short-circuited and beat wildly and develop a fatal arrhythmia called ventricular fibrillation. When the heart beats so wildly that it can’t pump blood effectively to the other vital organs the individual then dies. Over the past year, three student athletes were impacted with either a baseball, hockey puck, or lacrosse ball that has led to fatality. As you are well aware, in our first series of studies, we concluded that softer heavier baseballs and chest protectors that were then currently on the market, did not afford a statistically significant benefit to the individual. Needless to say, this was contrary to a number of marketing campaigns, which had been pushed on the unsuspecting public by a number of different manufacturers in the sporting good equipment industry. Our research team subsequently found that lighter mass baseballs did reduce the risk of the chest impact fatality scenario. It was the purpose of this study to investigate modified chest protectors that could reduce the fatality scenario. Of significant importance, the number one method of reducing this fatality scenario was teaching how the batter should avoid being hit in the chest with the pitch. Unfortunately, many individuals are never taught how to get out of the way of an errant pitched ball and in fact, walk into the pitch and sustain this fatal scenario. In this particular study published in the Journal of Trauma, we conclude one particular vest, the All Star vest, did reduce the risk of injury and fatality at the speeds tested of 40, 50, 60, and 70 miles an hour. The All Star chest protector was the only chest protector we found to be effective. Unfortunately even the most effective chest protector only provided a 61% reduction in potential cases of the fatal cardiac injury. Therefore, it is our contention that the manufacturers need to go back to the drawing board as it relates to the chest protector issue and develop improved materials and structures that could further diminish the potential risk of injury and fatality. In addition, it is also our contention that if this event occurs the most effective way of helping a downed athlete is the use of a defibrillator. It has been acknowledged in the medical literature that the most effective maneuver of breaking this fatal spiral is to defibrillate the injured athlete. Every community ball field and every sporting facility should have immediate access to a defibrillator.

Our study entitled: The Laboratory Analysis of a Preventive Intervention for Softball and Baseball: Standard vs. Break-Away Bases has been accepted for publication be the International Journal of Foot and Ankle. As outlined in previous updates the Institute has truly been on the forefront of injury prevention research as it relates to sliding related injuries. Our previous studies conducted at the University of Michigan and then carried over to the Institute have shown that break-away bases can reduce the risk of injury by up to 96% and reduce the health care expenditures by up to 99%. The product used in our studies that was effective was the Rogers Break-Away Base. It should be noted that over the years, a number of different manufacturers have tried to apply our research to their products in what we believe is a fraudulent manner. Therefore our research team compared the injury reduction capabilities of a number different types of break away bases that are currently on the market. What we did find was that when all break-away bases were compared to the standard stationary base, there was a significant difference amongst the break-away bases at reducing the risk of injury. We did find however that the Rogers Base reduced the risk of injury to a statistically significant degree in all scenarios that we tested. It is therefore our contention that all break-away bases are not of equal stature, and in fact the base that was the most effective at reducing the risk of injury was the Rogers Break-Away Base.

Our study entitled: The Evaluation of the Cumulative Concussive Effects of Soccer Heading in the Youth Population has also been accepted by the International Journal of Injury Control. As a number of you are aware, the Institute has taken a leading role in the issue of heading within the sport of soccer. In this particular field study over a two year time frame, we found at the conclusion of the second year of testing that there was a relationship between heading and information processing and memory ability. We found that as the amount of heading escalated there was a deleterious effect on information processing and memory. We do feel as though that these changes were only temporary in nature. However, in a previous study published in Oslo, Norway, in an older age group, the researchers did find that as the years progressed these changes could well become permanent. Our recommendations as it relates to this particular study are to 1.) Modify how children are being trained to head the ball in practice. It has been our experience that the vast majority of heading events in youth soccer are occurring in practice sessions. We have suggested that a lighter mass ball be utilized, such as a beach ball the same size as a soccer ball, to introduce the concept and technique of heading in practice. 2.) It is the firm belief that student athletes complaining of headache, nausea, vomiting, blurred vision, or double vision after heading a ball immediately be removed from play. In addition, it is of significant importance that the student athlete not be returned to play until their symptoms have completely dissipated. If their symptoms continue, they should be evaluated by a trained medical professional immediately. If a student athlete is sent back into competition, with ongoing symptoms, this could only lead to further and more significant injury event.

A number of ongoing research endeavors are in various phases of development in the Institutes laboratory on the campus of St. Joseph’s Mercy Hospital in Ann Arbor, Michigan. Under the direction of Ms. Beth Kedroske and Mr. Rajkumar Israel we are in the process of evaluating various types of products that could potentially reduce the impact of the ball to the head in the sport of soccer. To date there has been no comprehensive study of heading apparatus that are currently being made available to the public as far as the force reduction capabilities issues are concerned. In addition, we are further evaluating the chest impact fatality as is occurring in the sport of hockey. There have been several student athletes that have died getting hit in the chest with a puck as well as in the chest with a stick. The scenario is similar to the commotio cordis event, which I described in the sport of baseball. In a study involving Dr. David Viano, Dr. Cindy Bir, with Wayne State University as well as Ms. Beth Kedroske, Mr. Rajkumar Israel and Dr. Dave Janda, we are evaluating the effectiveness or ineffectiveness in the sport of hockey in reducing this potential fatal scenario.


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