Although the sports medicine community has not come to a consensus, there are two methods of objective testing that may satisfy the reasonableness test: neuropsychological testing and postural stability testing.

Neuropsychological testing measures the athlete's cognitive flexibility, attention span, orientation, concentration, visual-spatial capacity, distractibility, immediate memory recall, and problem-solving abilities. These tests directly measure the cognitive qualities that are affected by head injury and allow athletic trainers to objectively evaluate the athlete's condition.

The administration of these tests generally occurs in a clinical setting, although recent research indicates that athletic trainers may also administer neuropsychological tests on the sidelines and achieve valid results. The reasonableness test basically consists of assessing, treating and determining return-to-play decisions after an injury, an example of this is with the National Hockey League (NHL) and National Football League (NFL), which both use neuropsychological testing of an athletes cognitive awareness.

Similarly, researchers have established that postural stability tests are reasonable to use in determining when symptoms of concussion cease. These objective tests use sophisticated force plate systems to challenge sensory systems involved in balance by altering visual and support surface conditions. While it is not likely that athletic trainers will have access to this equipment it has been determined through scientific research that when these tests occur on the sidelines, there is more accurate postural stability tests.

One of the reasons that athletic trainers rely so heavily on subjective measures and personal intuition when evaluating an athlete with a head injury is that they have nothing for comparison. Athletic trainers and team physicians routinely conduct pre-participation examinations to determine if an athlete has a condition that would preclude participation in sports. Although reported legal decisions provide little guidance regarding the appropriate nature and scope of a standard pre-participation examination, many lawsuits allege that the sports medicine professional did not discover a medical condition that later resulted in injury or death.

Informed Consent

Generally the law has found that physicians who conduct a thorough pre-participation examination in conformity with accepted standards of practice are not liable for the athlete's injuries that occurred post examination. Sports medicine professionals should always consider the intensity and physical demands of the athlete's sport, all objective clinical evidence, and the probability and severity of harm from athletic participation given the athlete's condition. Liability for negligence occurs when an athlete does not receive full disclosure of information about continued involvement with a sport while suffering from a medical condition. This duty to disclose relevant information relates to the issue of informed consent.

Page 1 of 2 :: First | Last :: Prev | 1 2 | Next