My review is intended to give potential readers guidance as to what they might gain from reading this book. There are many different professions that can benefit from the information provided, although the compiling author had clinical neuropsychologists and psychologists in mind. I encourage anyone interested in sports, medicine, and sports related injuries to read some, or all, of this book, but note, not everyone will enjoy it due to the background knowledge necessary for understanding.
Style and Prose Critique
For the most part, the book is written in a conversational tone, which allowed me to get through some of the more technical sections with ease. The book is structured much like a review article, meaning it contains information from a broad range of studies and authors, mainly focusing on mild traumatic brain injuries (MTBI) and concussions. I liked the use of various authors to write about different aspects a neuropsychologist might face when entering the realm of sports neuropsychology.
The book is broken down into five main parts, each of which is broken down into chapters with more specific examples and explanations. The first part gives a basic history of sports in which head injuries historically appear. It also explains the need for study and management of sports related concussions. The author gives an objective view of pros and cons working with athletes and athletic teams. In this section, he encourages each neuropsychologist to carefully examine his or her motives for pursuing this specific field. As a whole, this part is interesting and gives a good background for the rest of the book; however, much of the historical information is not pertinent to current applications and might seem useless to some readers.
The second part of the book is by far the most technical. The intended reader should have no difficulty understanding the basic physiological and scientific information presented. This section tackles the difficult issue of defining what constitutes a concussion, the epidemiology of concussions, and clinically applying this knowledge in the sports arena. What I like best about this section is the author's use of sports jargon. For example, William B. Barr writes, "The terms `having one's bell rung' or receiving a `ding' are sports expressions used to describe when an athlete has received a relatively severe blow to the head" (Echemendía, p. 89). I've heard these terms used all my life playing football and rugby, and not once have I stopped and thought how we can dismiss what is potentially a serious brain injury with something as simple as a colloquial phrase. Some of the more important questions raised in this section are the cause and effect, both short and long-term, of MTBI on kids as well as adults. Some studies provide evidence to answer these questions, but for the most part, the scientific and medical communities know little about how concussions are caused (traditional versus rotational forces), and the effects of concussions. Evidence has shown that there are lower concussive thresholds for successive impacts, and that second-impact syndrome could have devastating consequences later in life ranging from cognitive impairment to even Alzheimer's. This section also provides the reader with information on how to assess MTBI on the "sideline," and what the guidelines for "return-to-play" should be.
The third part of the book aims to aid the neuropsychologist in starting and maintaining MTBI testing programs including elementary school, middle school, high school, college, and professional level athletes. I like the idea that these testing programs can be implemented in schools to educate and involve a majority of young athletes and parents that may not know anything about MTBI and the risks to which young athletes are exposed. I think more than just neuropsychologists can benefit from reading this section. For these programs to be initiated, public officials need to be convinced of the dangers of MTBI before any of them agree to spend money on a comprehensive and potentially expensive program. The author might have added advice as to presenting this information to those that might not fully grasp the physiological and developmental importance of the brain and its functions. Unfortunately, I think navigating the political or social community is a necessary evil in which the average neuropsychologist will have little to no experience.
The fourth section is specific to computerized neuropsychological test batteries. As a non-neuropsychologist I found this section to be the least useful or informative to me. Multiple tests are given including the ImPACT Neuropsychological Test Battery, the HeadMinder Concussion Resolution Index, CogSport, and Sports Concussion Applications of the Automated Neuropsychological Assessment Metrics Sports Medicine Battery. These all have slightly different criteria for assessing cognitive impairment, but what I took from the section is that computerized technology is a method for making neuropsychological testing quicker and cheaper which in turn will allow it to be used in a much more extensive manner when compare to traditional handwritten neuropsychological tests. This section is really only useful if the reader intends to implement some sort of computer based testing.
The fifth and final section gives the reader different perspectives when assessing, treating, and monitoring sports MTBI. Throughout the book, but especially here, the author(s) state the importance of collaboration when dealing with MTBI. Certified athletic trainers, team physicians, coaches, players (and parents), and neuropsychologists all must work together when either assessing or treating MTBI. The main goal is to prevent further injury to the player, while not being overly cautious so as to prevent the player from achieving necessary goals.
I think this book does a good job explaining many aspects of sports MTBI. For those interested in medicine as well as sports, I highly recommend reading and understanding the facts behind why some of your favorite sports players might not be allowed to play for extended periods of time from one little hit in a game. The implications for fantasy football could be enormous.