Updated November 12, 2013
One way for athletes, coaches, parents, officials, support staff and medical personnel to become educated about concussions is by downloading concussion "apps" on their mobile devices. Because of their widespread use, portability and wireless connectivity, mobile phones are, in the words of a 2013 study, [1] "uniquely placed," to address the "significant" gap in concussion education.
While there are, as of yet, no studies investigating the use of mobile devices for sports concussion education, diagnosis or management, the authors of the 2013 study identified two key advantages of mobile phone apps as educational tools: first, that they give the user the opportunity to download educational materials quickly, and, second, they possess operating systems that support engaging and interactive solutions to learning.
The study identifies a need for smartphone apps to organize information on injury demographics, symptom timing, recovery milestones, and medical appointments, in order to provide licensed health care professionals diagnostic screening tools, such as the Sport Concussion Assessment Tool (SCAT2/3) [1], that are easily accessible across computing platforms. But, the authors note, of the eleven applications they identified as being assessment tools, only four described the intended audience as health care professionals.
Concerned that use by parents and other non-medical personnel might carry significant legal liability, the authors of the study say "care should be taken to ensure that assessment tools are used exclusively by licensed health care providers."
There are currently 20 smartphone apps on sports concussions (including apps from the maker of the Shockbox helmet sensor [2], and the mobile version of the King-Devick test [3]). Seven provide educational materials intended for use by parents and athletes, two of which are designed specifically for educating children (Hockey Canada Concussion Awareness for Kids, and Barrow Brainball). Most, however, are designed for use by medical professionals, such as athletic trainers or team doctors, not by parents or coaches.
Here are our reviews
1. Concussion Recognition and Response (CRR) ($.99).
An excellent smart phone application developed by two top concussion experts, Gerard A. Gioia, PhD, a pediatric neuropsychologist and the Chief of the Division of Pediatric Neuropsychology at Children's National Medical Center, where he directs the Safe Concussion Outcome, Recovery & Education (SCORE) program, and Jason Mihalik, PhD, CAT(C), ATC, Assistant Professor in the Department of Exercise and Sports Science at the University of North Carolina, and co-director of the Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center.
The CRR app allows parents and coaches to capture and retain data on concussion incidents for a particular athlete and determining whether concussion is suspected by responding to a series of screen prompts:
In case of suspected concussion, the app prompts parents and coaches to remove the athlete from the game or practice right away and provides recommendations for follow-up care and management, including:
The app also includes helpful answers to concussions FAQs, with separate general FAQs and ones geared to coaches and parents.
This is an excellent and helpful concussion app, easy to navigate, and it puts at the fingertips of a coach, or parent or parent-coach most of the essential information they need for identifying a possible sports concussion and what parents need to do - and not do - in the first, critical 24 to 72 hours after suspected concussion. It is, in the view of MomsTEAM editors, the best concussion application for parents currently on the market.
Note: Before this application loads, the following box appears on the screen: "This application is not intended to replace seeking help from a trained medical professional. If the youth has lost consciousness, even briefly, call 911 immediately. Refer to the FAQs section for the complete disclaimer related to the application." The FAQs contain the standard legal disclaimer that the app is for "information and educational purposes only."
Highly recommended.
2. Concussion App from Sports Safety Labs LLC (free/$4.99),
The free version of this application:
An optional concussion diagnostic module, available via in-app purchase for $4.99, allows the user to capture and store for individual athletes the results of 11 tests based on the SCAT2 test to assist in the evaluation of the physiological and neurocognitive status of pre-concussion (baseline) and post-concussion (injured) athletes. The standardized presentation of the report and its data can be emailed from the user's smartphone to a physician to support their diagnostic interpretation of the athlete's condition. Physician's post-injury reports may be forwarded via email from the smartphone to a child's club or league if the user chooses to do so for rapid documentation and approval for return-to-play status.
The application provides a personal baseline testing program which compares the athlete's own post-injury results versus their own pre-injury results rather than to "norms" or population samples of other athletes who have also taken the test, and is designed to help the athlete and their doctor make accurate, personalized comparisons for return-to-play decision.
Pop-up prompts at various points during the testing indicate that the app is designed for use by medical professionals, not by parents.
In the opinion of the MomsTEAM editors, the free version might be worth a download for parents, if for no other reason than to utilize the Call 911 and Locating the Nearest Hospital features, but the one for $4.99 is really not designed for parents, so there is no point in shelling out five bucks for a test that isn't meant for a parent to use, and, as the 2013 study reviewing smartphone apps pointed out, shouldn't be used except by qualified health care professionals.
Free version: recommended.
$4.99 version: not recommended.
3. Play It Safe (free)
This free smartphone application from Concussion Health, LLC includes a 22-part test, including:
Once the test is completed, the app provides a result summary (red flag,yellow flag, green flag).
The application is unwieldy, as it doesn't include an explanation of why the 22 items are tested with the individual test modules, requiring the user to access the application's "Help" section to obtain such explanations. While the app says the tests can be performed by coaches, parents or other individuals involved in the athlete's care, it doesn't seem designed with any particular type of user in mind; the test modules are only loosely based on the SCAT2 test, and hence of questionable utility by a clinician in diagnosing a suspected concussion.
Not recommended.
4. Pocket SCAT2 (free)
A smartphone version which purports to replicate the SCAT2 test, but which doesn't even come close to doing anything of the sort. A total waste and completely useless, either as a diagnostic tool for suspected concussion or as providing basic concussion information. In any event, the SCAT2 (now updated to the SCAT3) is designed for use by clinicians, not parents or coaches.
Not recommended.
5. SCAT2 (free)
A smartphone version of the SCAT2 test intended for use only by qualified medical professionals, thus of no use for parents and coaches. With the March 2013 release of the SCAT3, expect this app to be updated soon.
Not recommended.
6. ImPACT Concussion Awareness Tool (ImCAT)(free).
As the application's name suggests, this app, from the folks who make the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), the most widely used computerized neurocognitive test for concussion management, provides information about concussions, but, unlike the others apps, is not a concussion testing tool.
The app includes:
While all the information on this app can be found in the MomsTEAM concussion center [11]and elsewhere on the Internet, it might not be a bad idea for parents and coaches, especially of teams without trained healthcare professionals, such as certified athletic trainers, on the sidelines to download so it is available for quick reference, just in case Internet access isn't possible.
Recommended.
7. Return2Play (University of Michigan Neurosport)(free)
Developed by the Pediatric Trauma Program at C.S. Mott Children's Hospital in partnership with Michigan Neurosport, this app is Intended tor use primarily as a management utility for concussion patients to track their recovery from concussion and doctor's appointments. The app also contains some brief - too brief, in the view of MomsTEAM editors, sections on:
Good information, but incomplete. Perhaps valuable for athletes who want to track their concussion recovery, but for parents, the CRR (#1 above) contains more complete information.
Not recommended.
8. Hockey Canada Concussion Awareness (free)
Developed as part of a larger initiative between Hockey Canada and three other not-for-profit organizations) and as part of the Canadian government's Active and Safe Injury Prevention Initiative, this app, while designed for hockey players, has some valuable information on concussions, even for parents who don't have kids playing hockey, including:
Good basic information, especially for hockey parents, but not of much value to parents with kids playing football.
Recommended for hockey parents; not recommended for football parents.
9. Hockey Canada Concussion Awareness for Kids (free)
The first concussion app designed specifically for kids, the app uses a character named "Puckster" to get information about concussions across to younger kids. It includes a simple video game kids can play in which Puckster skates over - or into - various obstacles on the ice with concussion tips on the board in the background, and easy-to-understand versions of the concussion recognition, treatment and return to play information in the regular app.
Recommended for young hockey players; not recommended for football players.
10. USA Football Heads Up Football (free)
Speaking of football, as the name suggests, this app explains all of the elements of USA Football's Heads Up Football program, which the organization touts as a comprehensive approach to player safety for leagues, parents, and coaches run in partnership with the NFL.
11. American Academy of Neurology's Concussion Quick Check (free)
Issued in conjunction with the AAN's updated concussion guidelines, [2] this is a useful and concise app true to its name, and is designed help parents, coaches, and other non-medical personnel determine if an athlete has a concussion and needs to see a licensed health care provider.
Like many of the other apps, the Concussion Quick Check includes:
Brooke de Lench is the Founder and Publisher of MomsTEAM.com and the author of Home Team Advantage: The Critical Role of Mothers in Youth Sports and Producer and Director of MomsTEAM's new high school football documentary, "The Smartest Team." [10]
1. Kutcher J, McCrory P, Davis G, et al. What evidence exists for new strategies or technologies in the diagnosis of sports concussion and assessment of recovery? Br J Sports Med 2013;47:299-303. (accessed March 21, 2013)
2. Giza C, Kutcher J, Ashwal S, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013; published online before print March 18, 2013; DOI:10.1212/WNL.0b013e31828d57dd.
3. McCrory P, et al. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. Br J Sports Med 2005;39:196-204.
4. McCory P, et al. Consensus Statement on Concussion in Sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Br J Sports Med 2009: 43:i76-i84
5. McCrory P, et al. Consensus Statement on concussion in Sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med 2013:47:250-258.
6. Meehan WP, III. Kids, Sports, and Concussions (Praeger 2011), p. 4.
Posted August 12, 2012; revised and updated November 12, 2013
Links:
[1] https://momsteam.com/node/1335
[2] https://www.theshockbox.com/
[3] http://kingdevicktest.com/
[4] https://momsteam.com/node/149
[5] https://momsteam.com/node/2700
[6] https://momsteam.com/node/128
[7] https://momsteam.com/node/221
[8] https://momsteam.com/node/145
[9] https://momsteam.com/node/3310
[10] http://www.thesmartestteam.com
[11] https://momsteam.com/node/305
[12] https://momsteam.com/node/3015
[13] http://barrowbrainball.com/
[14] https://momsteam.com/health-safety/concussion-signs-and-symptoms-physical-cognitive-emotional-sleep-related
[15] https://momsteam.com/health-safety/signs-requiring-immediate-hospitalization-after-concussion
[16] https://momsteam.com/health-safety/return-to-play/concussion-return-to-play-step-by-step-approach-recommended