For 14 weeks, NOW health reporter Cornelia Naylor has been assigned to undertake a “Fortius challenge,” setting fitness and performance goals and experiencing first-hand the many ways Burnaby’s Fortius Sport & Health can help. As a rehab project, the team will zero in on a lingering shoulder injury, but Cornelia will also get a chance to sample everything else Fortius has to offer, from massage therapy to diet advice and from vision testing to a scientific analysis of her running gait.
I am facing Fortius Sport & Health concussion manager Megan Durrant.
Between us is silence.
She has just asked me to repeat a series of numbers back to her in reverse order: one, eight, four, six, two.
“Two, four, six …”
It’s my third failed attempt at the five-number sequence.
“Don’t worry,” Durrant says. “It’s not a pass or fail thing.”
I’m not concussed, just really bad at numbers.
But if I had just had my bell rung during a football game, how would anyone know the difference?
Enter Fortius’s baseline concussion screening.
“We do this whole baseline assessment so we can get a better idea of who are you prior to your concussion injury,” Durrant says. “Each brain is really unique. … It’s much better, as a clinical tool, if you’re comparing it to yourself.”
Toward that end, Durrant is putting me through a battery of tests to measure everything from memory and reaction time to balance and neck strength.
The Fortius concussion program is fairly new, but as awareness about the seriousness of the injury – especially on developing brains – continues to grow, more and more parents and coaches of young athletes are bringing them in for baseline tests.
(Most professional and high-level college programs already have their own concussion protocols, according to Durrant, so the centre sees less of them.)
Fortius-tested athletes who are later suspected of having suffered a concussion come back to the centre to be retested against their baseline data three to five days after their injury and then again after Fortius concussion experts have taken them through a return-to-play concussion management program.
“We compare the pre and post to see if there’s anything that we’re missing still,” Durrant says.
Some of the tests during my hour-and-a-half assessment are low-tech but time-tried, like Durrant asking me to tell her what day it is, or measuring my reaction time with the “stick test.”
The latter involves a calibrated stick, weighted at the bottom with a hockey puck.
Durrant drops it between the thumb and fingers of my right hand.
My reaction time is measured by how far along the stick I grab as it falls.
Simple as it is, it’s among the most scientifically validated reaction-time tests around, according to Durrant.
Another low-tech test has her attaching a laser pointer to my head for a “relocation accuracy assessment.”
Sitting in a chair, I use my head to aim the laser at the centre of a bull’s-eye on a wall a few feet away.
After closing my eyes and turning my head, Durrant asks me to keep my eyes closed and try to re-point the laser at the middle of the target – kind of a pin-the-tail-on-the-donkey thing.
Some of my attempts end up on the wall, missing the target entirely.
Clearly these tests are designed to gauge cognitive limits, not make people feel great about their brain power.
“They try to trick you,” Durrant says.
She assures me, however, that any really alarming deficits uncovered during the tests would be flagged by a Fortius physician.
The results of my Cognigram – a computer test that measures memory and reaction time – for example, can only be interpreted by Fortius sport doc Dr. Jason Crookham.
“If there are any red flags, he would just reach out to you,” Durrant says.
So far, so good.
Another high-tech test involves a visit to biomechanist Jessica Maurer in the Fortius lab.
She runs me through a series of balance tests as I stand on a force plate capable of measuring the forces under my feet and the location of those forces within millimeters.
Part of the test just measures whether I can stand with hands on hips for 20 seconds in three different positions: feet together side by side, one foot off the ground, and one foot lined up directly behind the other.
I repeat the series with my eyes closed – it’s a lot harder.
Maurer then repeats the whole thing on foam blocks that make balancing even more difficult.
Besides measuring how long I can balance (less than a second in some positions with my eyes closed), the force plate measures how much I sway and how quickly.
For each segment of the test, Maurer’s computer generates a “centre of pressure trace” or COP.
“It’s basically like a scribble,” she says. “If someone’s really balanced, they’ll be like a pin dot. We know, that in general, small scribbles and slow movements mean good balance.”
My scribble is no pin dot, but there’s nothing alarming about my results either.
It’s cutting-edge stuff.
Although balance tests are a mainstay of concussion testing, quantifying sway patterns and speeds, and gauging how concussions affect them, is an emerging area that could lead to more accurate information about when athletes are really ready to return to play.
“That’s part of the goal of Fortius in general, to keep challenging what we know and trying to move it forward,” Maurer says.
For more information on the Fortius concussion program, visit www.fortiusconcussions.com.
Next stop, the physiology lab.
Follow Cornelia Naylor on Twitter, @CorNaylor
