Certified Concussion Management Specialists Training Resources


Instructions

This page provides an overview of the program agenda as well as links to required recorded sessions, important references, ancillary materials, and assessments.  Please be sure to login to each session at least 15 minutes early as we will spend a few moments going over important information prior to the start of the educational programming.  You must attend all sessions as scheduled.  There are no make-up sessions or refunds for failing to attend a required session.  Your attendance and participation is continuously monitored throughout the general sessions.

All participants will receive a follow-up email 1 hour after the final session.  Use the links in the follow-up email to link to this on-line syllabus page to view required recorded sessions and download ancillary materials.  You MUST register for and view all required recorded sessions.

There are 3 exams associated with this curriculum.  Each exam is made up of 10 multiple choice questions.  All exam questions are drawn directly from live webinar discussions, required readings, recorded sessions, and video demonstrations/learning labs.  A practice copy of each exam is provided below.  Use each practice exam as a guide when reviewing content as the questions reflect the salient points of the didactic material.  Upon completion of the training participants will be provided a link to each exam in a follow-up email.  ALL EXAMS MUST BE TAKEN USING THE EXAM LINKS PROVIDED IN THE FOLLOW-UP EMAIL.  No exceptions will be made.  Upon completion of each test participants will be provided the test score and the correct answers.  Review the correct answers for the questions missed and be sure to ask the instructor for clarification for any questions.  You MUST complete all the exams to receive your CMS credential.  Upon submission of each test you will receive the correct answers and a test score.  Note each test score as you will be required to report the score on your Request for Credentialing form.

In addition to the general sessions requirements, you MUST also complete a case study/essay project.   A link to this project is provided below.  Upon completion of all program requirements, CMS candidates MUST complete and submit the Request for Credentialing form.  You will not receive CMS certification without completion of ALL program requirements.  All program requirements MUST be completed and the Request for Credentialing form received by SMC within 30 days of completion of final instructor led session unless prior arrangements have been made with the program’s primary instructor.

All CMS candidates are required to be current holders of CPR with AED certification through either the American Heart Association or American Red Cross.  A copy of your certification card must be submitted with your Request for Credential form.

Recorded Sessions Participants
Click Here for Important Details

Use this link to submit all requirements to the CMS Program Director via email

SUBMIT REQUIREMENTS HERE


CMS Certificate Program Sample Syllabus

Case Report
The case report is intended to be a reflective project, focusing on a challenging incident involving head trauma resulting from organized athletic participation.  Your case report should involve an incident that did not follow a typical return to play track, but rather was complicated or protracted.  As you reflect on this particular case, you should pay particular attention to describing acute differential diagnosis,  not only explaining what the diagnosis was, but what else it could have been, and any clinical criteria used to make the differential diagnosis.  Management should focus specifically on how modifying conditions, risk factors, and the neurometabolic cascade influenced your acute management, rehab and return to play decisions.  As you examine this case be cognizant of what you did do and what you might do differently, providing a logical argument for what you propose that is grounded in differential diagnosis, the neurometabolic cascade, modifying conditions and/or risk factors.

Essay Requirement

Request-for-Credentialing


Monday, April 8, 2019

Live Session

10:45am – 11:00am ET: CMS Introduction
11:00am – 12:00pm ET: Mechanisms of Injury, Phase I: On- Field Management
12:00pm – 12:30pm ET: Optional Q & A Forum

Session Materials

To access recordings simply click on the Live Session Recording link.  When the registration window opens ignore the price, complete the registration info, select the Recorded Session option from the menu, and click Continue.  When the Payment Due window opens enter “Recorded” in the Enter Discount Code box and hit the Apply button.  Now you are free to enjoy my spine tingling presentation!  You will also note that I have uploaded a copy of the slides that correspond to the recording.  These can be downloaded by clicking on the day’s topic title found under the Live Session section for the day.

Recordings:

  1. Live Session Recording
  2. Recorded Session: None for today

Seminal Readings:

          1. McCrory P, Meeuwisse W, Dvorak J. et al. Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. Published Online First: [April 26, 2017]. doi:10.1136/ bjsports-2017-097699
          2. Cendoma MJ. A sideline assessment strategy that uses vital signs trending as a mechanism for identification of intracranial hematoma resulting from head trauma in sports. Unpublished manuscript, Sports Medicine Concepts, Livonia, NY. 2013.
            1. SMC Enhanced Differential Diagnosis Report©

Ancillary Readings / Materials:

          1. Echemendia RJ, Meeuwisse W, McCrory P, et al. The sport concussion assessment tool 5th edition (SCAT5). Br J Sports Med. Published Online First: [April 26, 2017]. doi:10.1136/ bjsports-2017-097506
            1. SCAT5© Sport Concussion Assessment Tool – 5th Edition
          2. Cantu RC.  Posttraumatic retrograde and anterograde amnesia: pathophysiology and implications in grading and safe return to play. J Athl Train. 2001;36(3)244-248.
          3. Davis GA, Purcell L, Schneider KJ, et al. The child sports concussion assessment tool 5th edition (Child SCAT5). Published Online First: [May 24, 2017]. doi:10.1136/ bjsports-2017-097492.
            1. Child SCAT5© Sport Concussion Assessment Tool
          4. SMC Cranial Nerve Assessment Guide©
          5. SMC Head Injury Warning Sheet©

CMS Quiz_1

You may use this link to download a copy of the quiz to help you as you complete readings.  However, you should use the links provided in the program follow-up emails to officially complete the all quizzes. 


Tuesday, April 9, 2019

Live Session

10:45am – 12:30pm ET: Acute Injury Differential Diagnosis and Sideline Assessment

Session Materials

Recordings:

  1. Live Session Recording
  2. Modifying conditions

Seminal Readings:

            1. Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl Train. 2001;36(3):228-235.
            2. Valovich-McLeod TC, Lewis JH, Whelihan K, Welch-Bacon CE. Rest and return to activity after sports-related concussion: a systematic review of the literature. J Athl Train. 2017:52(3):262-287.
            3. SMC Step-Wise Concussion Recovery Progression©
            4. Iverson GL, Gardner AJ, Terry DP, et al. Predictors of clinical recovery from concussion: a systematic review. Br J Sports Med. 2017;51:941-948.
            5. Teel EF, Marshall SW, Shankar V, et al. Predicting recovery patterns after sport-related concussion. J Athl Train. 2017:52(3);288-298.

Ancillary Readings / Materials:

          1. Babcock L, Byczkowski T, Wade SL, et al. Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department. JAMA Pediatr. 2013;167(2):156-161.
          2. Lau, BC, et al. Which on-field signs and symptoms predict protracted recovery from sports-related concussion among high school football players?  Am J Sports Med.  2011;39(11):2311-2318.
          3. Zuckerman SL, Yengo-Kahn AM, Buckley TA, Solomon GS, Sills AK, Kerr ZY.  Predictors of postconcussion syndrome in collegiate student-athletes. Neurosurg Focus. 2016 Apr;40(4):E13.

Wednesday, April 10, 2019

Live Session

10:45am – 12:30pm ET: The Neurometabolic Injury Cascade as a Foundation for Assessment, Recovery, and Rehab

Session Materials

Recordings:

          1. Live Session Recording

Seminal Readings:

            1. Ellis MJ, Leddy JJ, Willer B.  Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment. Brain Inj. 2015;29(2);238-248.
            2. Kontos AP, Deitrick, JA, Collins, MW, Mucha, A. Review of vestibular and oculomotor screening and concussion rehabilitation. J Athl Train. 2017;52(3):256-261.
            3. Leddy J, Baker JG, Haider MN, Hinds A, Willer B.  A physiological approach to prolonged recovery from sports-related concussion. J Athl Train. 2017;52(3):299-308.
            4. Leddy J, Kozlowski K, Fung M, Pendergast DR, Willer B. Regulatory and autoregulatory physiological dysfunction as a primary characteristic of post concussion syndrome: implications for treatment. Neuro Rehab. 2007;22:199-205.
            5. Leddy J, Willer B. Use of graded exercise testing in concussion and return to activity management. Curr Sports Med Rep.  2013;12(6):370-376.

Ancillary Readings / Materials:

            1. Vidal PG, Goodman AM, Colin A, Leddy JJ, Grady MF. Rehabilitation strategies for prolonged recovery in pediatric and adolescent concussion. Pediatric Ann. 2012;41(9):1-6
            2. SMC Medically Supervised Exercise Prescription©
            3. VOMS: A Brief VOMS Assessment to Evaluate Concussions: Preliminary Findings
            4. VOMS: Tests
            5. SMC Enhanced VOMS for Concussion
            6. Ask Dr. Jo explains Vertigo Exercises
            7.  Hallpike-Dix
            8. Canalith Repositioning
            9. BESS manual 310
            10. Abnormal pursuits/saccades

CMS Quiz_2

You may use this link to download a copy of the quiz to help you as you complete readings.  However, you should use the links provided in the program follow-up emails to officially complete the all quizzes. 


Thursday, April 11, 2019

Live Session

10:45am – 12:00pm ET: Symptom Provocation in Expose-Recover Therapy Models

Session Materials

Recordings:

          1. Live session recording
          2. Recorded Session: Implementation of Model Concussion Policy
          3. Step-Wise Recovery Progression

Seminal Readings:

Ancillary Readings / Materials:

          1. Sample Policy Binder
          2. Physician Concussion Evaluation Form
          3. emergency department discharge form
          4. Coaches Guidelines for management of acute concussions
          5. Facts and Falacies
          6. Sec 504 Fact Sheet
          7. FERPA Regulations

Program Evaluation:  Please note that the program evaluation must be completed using the link found in your follow-up email.  No exceptions can be made.

CMS Quiz_3

You may use this link to download a copy of the quiz to help you as you complete readings.  However, you should use the links provided in the program follow-up emails to officially complete the all quizzes. 

15 Comments

  1. Awesome – wouldl ike your thoughts on helmet removal of the speedflex helmets and some of the shoulder pads they have now – I would like to know if you can cut through the leather since they are not lace-ups

  2. I have a question to pose to the class. When an athlete gets hit, complains of “concussion-like symptoms” or is pointed out to you by a referee how do you decide whether they are taken out of the game and placed in your concussion protocol or allowed to RTP? Or asked another way, what is the clinical criteria for placing an athlete in the concussion protocol vs. allowing them to RTP after coming off the field; what is your criteria for crossing the line?

    I know that I hold kids out with any S/S of concussion, but I struggle with what is a S/S vs. what is an anecdotal complaint, emotional response, or relying on the observation of a less trained individual. I could sit 6 players on any give football game.

  3. In prep for the remainder of our remaining sessions, I did a re-read of the 2017 Consensus Statement (found on your CMS Resources Page). Interestingly, I found some insight regarding my previous post on when the clinical criteria for SRC line is crossed. See quotes followed by my interpretation.

    “The SCAT5 currently represents the most well-established and rigorously developed instrument available for sideline assessment.”

    This is telling me to use the SCAT5

    “Players with a suspected SRC following a significant head impact or with symptoms can proceed to sideline screening using appropriate assessment tools—for example, SCAT5. Both groups can then proceed to a more thorough diagnostic evaluation, which should be performed in a distraction-free environment (eg, locker room, medical room) rather than on the sideline.”

    This is telling me we can use the SCAT5 to help us decide if an athlete may have a SRC. A normal SCAT5 may indicate the possibility of RTP. If a possible SRC is indicated on the SCAT5, they are taken to the training room for further assessment by physician. If there is no physician to consult with, they enter the concussion policy. A physician knowledgeable in SRC management may permit same day RTP following further medical evaluation.

    “It is recognised, however, that abbreviated testing paradigms are designed for rapid SRC screening on the sidelines and are not meant to replace a comprehensive neurological evaluation; nor should they be used as a standalone tool for the ongoing management of SRC.”

    This is telling me that the SCAT5 can help me rule out a SRC on the sideline, but do not replace the need for physician referral when a potential SRC is identified on the SCAT5 and that the SCAT5 becomes less helpful in managing RTP longterm.

    Thoughts?

    1. Its your feeling that when an athlete is evaluated using what ever tool on the sideline and after athlete has a normal acting SRC at that time he should be evaluated by a physician as soon as possible? I use parts of SCAT for sideline evaluation then symptom scoring and tracking followed by IMPACT. We aren’t required to send to DR until full activity release . Evaluated by trained health care professional is how its stated with UIL Texas and The IMPACT people as well. I understand liability but if you are doing the rite things and documentation is there that’s what we do. We have had parents take their kids to there GP DR and we get back some of the most head scratching notes and also CT scans ordered as well. From what I here and read from other sources and you may have said it as well ATC my be able to fully release athlete in near future. I may be just dreaming all this.

      1. Thanks for the question Arnie. We only require athletes who present with signs and symptoms of concussion on standardized testing to be seen by a physician. We often receive notes back from the physician that state the athlete can return to play upon completion of the concussion policy as directed by the athletic trainer. Other times the physician will want to see the athlete and all of our progress notes prior to final release of the athlete. But, yes. It is our policy that if an athlete presents with signs and symptoms of concussion, they are seen by a physician prior to initiation of our policy.

        Mike

  4. Questions for today’s presenter…. First, thank you for your studies that show low-grade exercise can improve outcome then cocooning the athlete. You mentioned that athletes may suffer from depression due to prolonged concussion symtpoms at about the 2-3 week mark. One of your treatment strategies you mentioneed was postural training. I think most of us notes that the head down, forward rounded shoulder is the posture for depression (which amazing our culture encourages that posture, as it’s how we design our chairs and technology that encourages that rounded shoulder posture. Hence, often times leading me to wonder is it the posture that is causing depression or vice versa). I guess my question is have you noted athlete’s posture affecting outcome or prolong recovery in what you anticipated to be a mild concussion? And do you check for dyfunctional breathing patterns, (ie exhale is much longer than with inhale, which is typical in person with depression). Also, have you noted poorerr outcomes in those athletes with poorere diets (ie processed and high in sugars)?

  5. Just a follow up on my question concerning Dr referral for SRC is that that just your policy or state to send them for initial diagnosis. You obviously and in some cases we know more about concussion than the GP docs. Some have an understanding but most will give a time to return and as you said your policy and protocol as well as ours will trump what they say. It seems like referring every ankle sprain to be evaluated for minimal gain. Refer if necessary but not until Return to full activity seems to be where we stand now. I love the course and look forward to finishing and then sharing information to others.

    1. I agree. That is why I typically institute the 72 hrs rule. If an athlete takes advantage of the 72hr rest recommendation, chances are reasonable that they return to the AT for reassessment with signs and symptoms. If this is the case, they may not be referred to an MD. But if they return after 72hrs with remaining concussion-like symptoms, they will certainly be referred. I will also refer to an MD anytime the injury strays, at all, from our present understanding of a typical concussion sign and symptom pattern. Of course, you must also follow state, local, and institution policy in every case.

      Mike

  6. What do the NFL people do in the blue tent? Small part of scat? Vital signs trending, probably not. I f they take them to locker room maybe more detailed. They seem to return to sideline quickly not to play always but quick.

    1. The blue tent is used primarily for privacy during sideline injury assessment. It protects HIPPA rights by keeping prying eyes and cameras off the athlete and medical team while providing a more stable sideline environment for the medical team to complete preliminary injury assessment. It is used to conduct a sideline assessment to determine if the athlete needs to go back to the training room for further assessment or if the athlete is able to return to play.

    2. As far as concussions go, yes. They may do a preliminary concussion assessment. If the medical team finds evidence of concussion-like symptoms that they want to explore more in-depth, they are taken back to the training room. If nothing is found, they may be permitted to RTP.

      1. OK I apologize for not letting the Dr referral question go but more than likely if it is a legit concussion after 72 hrs they probably will still have signs and symptoms because as we know average recovery is 7-10 days. Still my point is if we are evaluating properly and it has already been 72 hrs which would make it less likely any emergency situation is going to present its self plus you gave proper instructions for parents to watch for decline in athlete and that didn’t happen what will the Dr add to the process of care at this time. Again refer for all the reasons that would point to unusual or decline but normal SRC ? Liability? If we are documenting everything and logging daily. Why Dr at that point?

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