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UC Bearcats train the eyes to save the brain

UC football faces concussions head-on with vision training that helps players make split-second, brain-saving decisions

by Melanie Titanic-Schefft

Media contact: John Bach, 513-556-5224

Published October 2014

As the football world struggles with how to deal with the health effects of big hits on the field, an off-the-field collision of science, sports and medicine at the University of Cincinnati may hold the most promising answer to the concussion conundrum.

While the number of diagnosed concussions is rising in many programs nationwide, UC’s football team has seen a stark contrast. In fact, since 2009, the team’s average number of concussions has dipped from 8.75 a year (2006-09) to just 1.3 (2010-13) –– an 85 percent reduction. And according to the experts involved, their success is mostly about prevention.

Joe Clark, professor of neurology and associate director of the UC Sports Neuroscience Initiative (SNI), is part of a holistic concussion prevention program at UC that has helped athletes strengthen their peripheral vision, reaction time and eye-hand coordination. To do this, he uses Dynavision D2 light boards in UC’s training rooms to teach the athletes’ brains to prepare their bodies more efficiently for surprise blindside hits and hard, head-to-head contact.

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Research has shown that absorbing blindside hits and brute-force helmet-to-helmet impact more effectively can make all the difference in whether a player takes a tough bang or suffers a concussion, which according to Clark is the result of the free-floating brain sloshing against the inside of the skull.

“The players have not only learned to react better, they also trust their peripheral vision much more,” Clark says. “When they see something coming now, they don’t have to look and verify what to do. They have that extra time of knowing it’s coming so they can tense their neck and core muscles and prepare instinctively to absorb the hit, or even evade it."

Lighting new pathways

The Dynavision training device is a large 5-by-7 foot electronic board that contains a set of 64 lights radiating outward from a central screen. The computerized system trains players to read the field more skillfully.  

For example, a quarterback stands facing the board concentrating on one area as if keying in on a primary receiver. But he also has to see and sense what’s in his peripheral vision. To do this, a 5-digit number flashes on the center of the screen for a few seconds. The trainers then ask him to read the number aloud after it has disappeared. Clark says this exercise trains the player to see something, put it into his head and then use it later to take a mental picture of the field.  

These exercises are invaluable for slowing down the field of play, he explains, as players learn to take in more information and synthesize it faster. 

“Ultimately we train their brains as well as their eyes and their hands using these programs,” says Clark. “We also have players stand on balance balls while performing the tasks, which enhances their ability to multitask.” 

The researcher also varies vision-training methods depending on position groups.

“The players that benefit the most from this board are the quarterbacks and defensive backs who have to do a lot of thinking and reacting,” says Clark. “They get a lot of sensory input through the eyes, so this really helps them. The linemen, however, benefit as well, especially when we alter the task to make the lights flash in the lower half of the board, because linemen have to control someone in the chest area.” 

School of 'preventing' hard knocks

UC football head trainer Bob Mangine is especially interested in the sports neuro-training that Clark brings to the team. “Up until five years ago, research on concussion predominately dealt with after-the-fact neuro-issues," Mangine says. “They would say, ‘what do we do with these kids who have chronic traumatic encephalopathy or with the older players who now have dementia?’”

But everything changed several years ago when Mangine met Clark, who was a sports trainer before becoming a neuroscientist.

“Joe’s background is in mild traumatic brain injury in the emergency room, and he is also a neuro-researcher,” Mangine says. “And my job is to get through 12 games in a season with the least amount of injuries as I can.

“It’s no longer a relationship of a research scientist and a clinician. Joe Clark lives with us and breathes with us, and the goofy ideas we come up with have made some positive changes that have really paid off.”

UC’s Sports Neuroscience Initiative also includes Dr. Angelo Colesimo, an orthopedic specialist, and Dr. Jon Divine, head team doctor.

“It wasn’t really any one of us, it was the whole SNI team who came together to bring UC to the forefront of bringing safety to our athletes,” says Mangine. “We undertook the project of concussion prevention and safety because of what we could each bring to the table.”

UC’s SNI team is on hand at every game to evaluate the Bearcats following an injury. “We all play off of each other whereby if one of us decides to put an injured player back into the game, all four of us have to agree,” says Mangine.

UC’s four Dynavision light boards, donated by Geraldine Warner, a member of UC’s board of trustees, are included in campus training rooms for many sports. The technology has a 20-year history of enhancing the peripheral vision of fighter pilots and improving coordination for patients in rehab facilities. 

UC’s football training facility also has a diagnostics machine called Optical Coherence Tomography (OCT) that Clark says is not in any other training room in the country. The machine performs retinal imaging that can be critical for concussion diagnosis, especially since most concussions also produce visual changes. Clark adds the hi-tech tool to a cadre of neuropsychological tests to help confirm concussion. 

Research beyond just football

When he isn’t working directly with athletes, he continues to research the neuro-development of the brain on a cellular level. Clark says there are currently several scientific “slosh” studies that focus on the environmental factors that affect the dynamic spacing between the brain and the skull. These studies take a pragmatic look at how younger brains are affected by concussion and the sloshing of the brain against the inside of the skull and the long-term effects. 

"We know that younger brains are not finished myelinating until about the age of 25 or 26, so these high school and college players’ brains are not done developing,” says Clark.

“So it’s these developing brains that we have the most concern with because we are still looking at what happens to that development under injury conditions. And until that correlation is completely understood, we do everything we can to enhance visual processing speed and injury prevention.”

Related article: 
Big impact: UC grads help Bengals diagnose and treat concussions

- Melanie Titanic-Schefft is a senior journalism student and writing intern with UC Magazine