App Makes Athletes Think About Concussions
UA engineering and biomedical researchers are building a virtual-reality experience targeting concussion awareness, to encourage NCAA football players and other student-athletes to report the real thing.

By Jill Goetz, UA College of Engineering
Sept. 23, 2015

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The UA's concussion app team : Ricardo Valerdi, Jonathan Lifshitz and Dr. Hirsch Handmaker
The UA's concussion app team : Ricardo Valerdi, Jonathan Lifshitz and Dr. Hirsch Handmaker (from left)

Sports-related concussions have sparked a national debate, multiple lawsuits and new concussion-management protocols in the NCAA and NFL in the last few years. Despite all the attention to concussion and its risks, many student-athletes either don’t recognize the signs of concussion — or won’t report them if they do.

But give these players just 10 minutes with an app that puts users on a virtual athletic field and shows them the immediate and delayed side effects of concussion, and it just might change their behavior and attitude toward head injury.

"The more student-athletes know about concussion and the risks of hiding symptoms, the more confident they’ll be in making the right choices," said Ricardo Valerdi, associate professor of systems engineering at the University of Arizona College of Engineering. "And the right choice is simple: Don’t play through a suspected concussion."

Valerdi, with Dr. Hirsch Handmaker and Jonathan Lifshitz at the UA College of Medicine–Phoenix, is building the app for the NCAA Mind Matters Challenge, part of a $30 million joint initiative with the U.S. Department of Defense to educate student-athletes and soldiers about concussions. The app is designed as a tool for athletic training programs.

"The mindset we have to overcome in educating athletes about concussions begins early in their lives," said Handmaker, research professor of radiology, whose CACTIS Foundation and Conquering Concussions organizations work to advance diagnosis, treatment and education on head trauma injuries.

Athletes want to conquer fear and get back in the game to show how tough they are and protect their status on the team. "This mentality, unfortunately, results in underreporting of head blows, which can lead to serious short- and long-term consequences from a second concussion before the brain has been allowed to heal," Handmaker said.

The investigators have made it to the second round of the contest, securing $100,000 to build a prototype and earning a chance to see the app released to athletes. They will present their prototype this winter to NCAA officials, and the winning approach to concussion education will be made available to some 400,000 NCAA student-athletes.

Double Vision on Demand

The free app, which uses the Google Cardboard open-source virtual reality platform, will be compatible with any smartphone. Google Cardboard is a foldout cardboard mount with lenses, magnet and fasteners. Assembled, with a smartphone slipped inside, it becomes an instant virtual-reality headset. 

"You’re a soccer goalie. You see the field in your headset, hear the crowd on your headphones. You just got hit, but exhibit no side effects that are obvious to your coach or trainer. Then an avatar coach enters your field of vision and says, 'You have just experienced a concussion. This is what it feels like.' Suddenly, your vision gets blurred, you experience double vision," Valerdi announced, commentator-style.

"It’s the penalty kick — the game is on the line. The pressure is on," continued the avid sports fan and founder of Science of Sport, which uses baseball, soccer and other sports to teach middle-school students STEM-related subjects.

It’s in game-changing moments like this that student-athletes often choose, or feel pressured, to play through a concussion. The app’s avatar coach may offer advice not just on identifying symptoms but also on reporting possible concussion symptoms and getting more information.

Concussion is a traumatic brain injury that occurs when a sudden blow — usually, but not always, to the head — disrupts brain function. While approximately 10 percent of concussions cause loss of consciousness, most produce less-visible effects, including short-term memory loss and loss of concentration, headache, nausea, dizziness, blurred and double vision, and ringing in the ears. The symptoms may subside quickly.

'A Really Big Headache'

David Roberts III knows how insidious concussion can be.

During the fourth quarter of a UA football game at Stanford on Nov. 6, 2010, the former Wildcats wide receiver was leaping for the ball when he was hit by a defensive back. His head was driven into the ground.

"I couldn’t answer the same question my trainer, Randy Cohen, asked me over and over," Roberts recalled. "I couldn’t name the president of the United States." But later that night, Roberts said, "other than a really big headache, I felt like I was back."

He passed the concussion test every Wildcats football player takes as a baseline before his first season and any time a concussion is suspected — and yet team trainers and doctors still held him out of the next game.

"Theoretically, I should have played the game against USC the following week," said Roberts, a UA aerospace and mechanical engineering graduate. "But my trainer wouldn’t allow it, and my UA doctors agreed."

Watching that game from the Arizona Stadium sidelines was not easy.

"I’m a California guy — I grew up watching USC. But in the end, I’m glad the University didn’t pressure me to play," Roberts said.

Roberts played football the rest of that season and his senior year before receiving his bachelor’s degree in 2012. He feels no ill effects from the concussion, he said, and enjoys his job at Boeing.

"I knew nothing about concussion as a kid growing up," he said. "If you got hit playing football, people would say, 'Oh, you just got your bell rung.' 

"It’s pretty amazing to think a kid might be able to put on a simulator and experience what it feels like to have a concussion, so that if he does get hit, he thinks, 'I know what this is.'"

Unlike Roberts, many players with concussion keep playing, even at a high level sometimes, putting other players at risk because of delayed reaction time associated with concussion — and putting themselves at risk of reinjury.

"Our message is this," Handmaker said. "In addition to increasing their health risk, athletes are hurting their teams by playing while impaired."




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