Lucas Bauer1, Morgan Mitchell1, Lexi Berry1, Ashley Hiatt1, Bethany Doom1, Zach Woods2, Jeffry Grassmeyer1,

Holly Showalter, Ph.D.1 1 Waukee APEX, Waukee High School, Waukee, IA; 2 Clarke County Hospital, Osceola, IA

AbstractCurrently in today’s society there is growing

controversy over the staggering number of

concussions athletic teens receive. There have

been many national statistics about concussion

related issues, but has there been any studies in

Waukee, Iowa? This Twitter poll study was

conducted to compare and contrast the rates of

athletic teen concussion related issues from

Waukee High School to the national average. A

recent survey from Waukee High School athletic

students suggests that current concussion related

issue rates in Iowa are higher than the national

average. The average rate of concussions in

athletic high school students nationally is 20%1,

while the student reported average rate of

concussions in Waukee High School is 47.1%.

The average rate of athletic high school students

nationally hiding a concussion is 27.5% while the

average rate of athletic high school students in

Waukee High School hiding their concussion is

31.4%. In conclusion, there are statistically

higher rates of concussion related issues in

Waukee than the national average. This matters

because the concussions today can affect the

health issues tomorrow.

IntroductionIn the U.S., concussions have been in the media

lately and have been a hot topic with high school

sports. In the last 10 years, the CDC reported

that the amount of concussions has doubled. 1

The American Academy of Pediatrics states that

the amount of emergency room visits for kids

ranging from 8 to 13 years has doubled and the

amount of concussions from teens ranging from

14 to 19 years has increased by 200% from

1997-2007. 2 In Iowa, all athletes and parents are

required to sign a state mandated concussion

form as shown in Figure 1. We hypothesized

rates would be lower for Waukee due to better

quality equipment and more awareness with

families and students.

Figure 1. Iowa Student Concussion Form

Methods⚫️ Waukee high school athletes were surveyed

on Twitter in Fall 2015 using a Google survey

questioning them about concussions and the

sports they participate in at Waukee High School.

⚫️ APEX collected and analyzed the data to

statistically prove that Waukee is either significant

or not significant with the data of Waukee

reported concussions compared to the National

average.

⚫️ To prove that Waukee does or does not have a

statistically significant difference in concussion

rates, we used the Z-score.

Results

DiscussionAfter we found the results, we decided to discuss

them with our high school football coach, Mr.

Scott Carlson. One option discussed was that

many students stated they had a concussion, but

a doctor didn't necessarily diagnose it. There

could be over-reporting in our survey because we

did not access medical records of the students to

verify results. Some concussions could be more

or less severe than others. Mr. Carlson does

want to see improvements in high school football

overall. He suggested blood tests to diagnose

concussions, improvements to the teaching of

football and the equipment as possibilities. Mr.

Carlson wanted to use a test of basic information

that they test at the beginning of the season to

see if they can answer the questions the same

way to see if they suffer from a concussion or

head trauma from a big hit.

ConclusionsIn this study, our objectives were to 1) evaluate if the State

of Iowa mandated concussion form that all athletes must

sign is adequate, 2) raise awareness about concussion

related issues for high school students, and 3) advance our

professional skills. In conclusion, we were wrong with our

hypothesis and we found that concussion rates seem to be

higher in Waukee than the National average. The higher

rates could be linked to higher medical awareness and

treatment in our district. More medical based scientific

studies would need to be conducted in order to assess

these theories. In the future, we would like to compare

legislation between different state governments over athletic

high school students and have surveys in those states. Now

one question we have where do we go from here? We

would like to specifically compare high schools in Iowa and

in other states. We would like to compare the types of

legislation and the effects on it for concussion related

issues. We believe legislation is another potentially

significant factor in concussion related issues.

AcknowledgementsWe would like to thank Dr. Showalter for giving us this

project and allowing us to learn more about teen concussion

related issues. We would also like to thank Bethany Doom

and Ashley Hiatt for pioneering this study with Zach Woods.

We thank Jeff Grassmeyer for teaching us about the

statistics and thank Scott Carlson for his thoughts on our

project.

References1. "Head Case - Complete Concussion Managements."

Stats on Concussions & Sports -. Head Case, 2013. Web.

28 Mar. 2016.

2. Bakhos, L.L., Lockhart, G.R., Myers, R., Linakis, J.G.

“Emergency Department Visits for Concussion in Young

Child Athletes”, Pediatrics, 2010; 126, e550-e556.

3. Doyle, Kathryn. "High School Athletes Often Playing with

Concussions." Reuters. Thomson Reuters, 2014. Web. 28

Mar. 2016.

Teen Concussion Study:

Waukee High School Students Comparing and Contrasting the Rates of Athletic Teen

Concussion Related Issues from Waukee High School to the National Average

Figure 2

Figure 3

Reported Concussions

%ReportedConcussions(Nationally)

%ReportedConcussions(Waukee)

20% 47.1%

p<0.01Z-Score=2.648 WaukeeTestValue=5.65

Result:WaukeeStatistically Higherin

Concussions

WouldHideaConcussion

%Reported(Nationally)

%Reported(Waukee)

27.5% 31.4%

p<0.01Z-Score=2.648 WaukeeTestValue=0.731

Result:WaukeeStatistically Similarto

NationalData

What is a concussion?

A concussion is a brain injury. Concussions are caused by a

bump, blow, or jolt to the head or body. Even a “ding,” “getting

your bell rung,” or what seems to be a mild bump or blow to the

head can be serious.

What parents/guardians should do if they think

their child has a concussion?

1. OBEY THE NEW LAW.

a. Keep your child out of participation until s/he is cleared to

return by a licensed healthcare provider .

b. Seek medical attention right away.

2. Teach your child that it’s not smart to play with a concussion.

3. Tell all of your child’s coaches and the student’s

school nurse about ANY concussion.

What are the signs and symptoms of a concussion?

You cannot see a concussion. Signs and symptoms of concussion

can show up right after the injury or may not appear or be noticed

until days after the injury. If your teen reports one or more symptoms

of concussion listed below, or if you notice the symptoms yourself,

keep your teen out of play and seek medical attention right away .

STUDENTS:

If you think you have a concussion:

• Tell your coaches & parents – Never ignore a bump or

blow to the head, even if you feel fi ne. Also, tell your coach if

you think one of your teammates might have a concussion.

• Get a medical check-up – A physician or other licensed

health care provider can tell you if you have a concussion, and

when it is OK to return to play.

• Give yourself time to heal – If you have a concussion,

your brain needs time to heal. While your brain is healing,

you are much more likely to have another concussion. It is

important to rest and not return to play until you get the OK

from your health care professional.

IT’S BETTER TO MISS ONE CONTEST THAN THE WHOLE SEASON.

HEADS UP: Concussion in High School Sports

A FACT SHEET FOR PARENTS AND STUDENTS

The Iowa Legislature passed a new law, effective July 1, 2011, regarding students in grades 7 – 12 who participate in

extracurricular interscholastic activities. Please note this important information from Iowa Code Section 280.13C,

Brain Injury Policies:

(1) A child must be immediately removed from participation (practice or competition) if his/her coach or a contest of fi cial observes

signs, symptoms, or behaviors consistent with a concussion or brain injury in an extracurricular interscholastic activity .

(2) A child may not participate again until a licensed health care provider trained in the evaluation and management of concuss ions and

other brain injuries has evaluated him/her and the student has received written clearance from that person to return to partic ipation.

(3) Key defi nitions:

“Licensed health care provider” means a physician, physician assistant, chiropractor , advanced registered nurse

practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

“Extracurricular interscholastic activity” means any extracurricular interscholastic activity , contest, or practice,

including sports, dance, or cheerleading.

Signs Reported by Students:

• Headache or “pressure” in head

•Nausea or vomiting

•Balance problems or dizziness

•Double or blurry vision

•Sensitivity to light or noise

•Feeling sluggish, hazy, foggy, or groggy

•Concentration or memory problems

•Confusion

•Just not “feeling right” or is “feeling down”

PARENTS:

How can you help your child prevent a concussion?

Every sport is different, but there are steps your children can take

to protect themselves from concussion and other injuries.

• Make sure they wear the right protective equipment for their

activity. It should fi t properly, be well maintained, and be worn

consistently and correctly.

• Ensure that they follow their coaches’ rules for safety and the

rules of the sport.

• Encourage them to practice good sportsmanship at all times.

Signs Observed by Parents or Guardians:

• Appears dazed or stunned

•Is confused about assignment or position

•Forgets an instruction

•Is unsure of game, score, or opponent

•Moves clumsily

•Answers questions slowly

•Loses consciousness (even brie fl y)

•Shows mood, behavior, or personality changes

•Can’t recall events prior to hit or fall

•Can’t recall events after hit or fall

Information on concussions provided by the Centers for Disease

Control and Prevention.

For more information visit: www.cdc.gov/Concussion

IMPORTANT: Students participating in interscholastic athletics, cheerleading and dance; and their parents/guardians; must annua lly sign the acknowl-

edgement below and return it to their school. Students cannot practice or compete in those activities until this form is signed and returned.

We have received the information provided on the concussion fact sheet titled, “HEADS UP: Concussion in High School Sports.”

Student’s Signature Date Student’s Printed Name

Parent’s/Guardian’s Signature Date Student’s Grade Student’s School

May2012-CE