MEDIA ALERT Bridging the Gap on Best-Practices in Concussion Management A National Symposium

1. MEDIA ALERT Bridging the Gap on Best-Practices in Concussion Management A National Symposium WHAT: St. David’s HealthCare presents Concussion Compliance’s “Bridging the Gap on Best-Practices in Concussion Management.” This day–long program is tailored to medical professionals who will be educated by medical experts and practitioners on the issues dominating today’s best-practice concussion management discussions and how to incorporate the use of several tools into clinical practice. This program provides an overview of the current best practices and consensus statements on concussion management, the latest scientific research, an update on tools available to practitioners, and perspectives from experts in concussion management. Approximately 500 area residents are expected to attend. WHEN: March 2, 2013, 9 a.m. Media representatives are invited to meet the symposium spokespeople and conduct interviews. WHERE: Norris Conference Centers, 2525 West Anderson Lane, Austin Texas 78757, Phone (512) 451-5011 AVAILABLE: Stephen Erickson, MD - Dr. Erickson serves as the medical consultant for Major League Baseball caring for the umpires and serves on the Major League Baseball Medical Advisory Committee and the Major League Baseball Mild Traumatic Brain Injury Committee. He also serves on the Arizona Interscholastic Association Medical Advisory Committee. Dr. Erickson is a fellow of the American College of Physicians and Adjunct Instructor in Medicine for the Mayo Clinic.  Paul Saenz, DO- Dr. Saenz is board certified in both Family Practice and Sports Medicine and is an associate clinical professor at the University of Texas at San Antonio Medical School and the University of North Texas Health Science Center. He serves as a team physician for the NBA San Antonio Spurs, the WNBA Silver Stars, the San Antonio Missions Double A Baseball Club, San Antonio area high schools and universities. Representative Four Price - Representative Four Price, R-Amarillo, authored House Bill 2038 (Natasha’s Law) and will read an official Proclamation from Governor Perry’s office proclaiming March as Concussion Awareness Month in Texas. Natasha Helmick- About a year ago, Texas Governor Perry signed HB 2038, commonly referred to as Natasha's Law.  The law, named for Natasha Helmick, a Texas State University athlete whose soccer career ended after five concussions in four years, applies to interscholastic athletic activity, including practice and competition, sponsored or sanctioned by a school district, a public school, including a charter school, or the University Interscholastic League.

2. AVAILABLE: Spanky Stephens, ATC - Mr. Stephens currently serves as the TSATA Executive Director. Mr. Stephens was associated with UT athletics for more than 30 years. He joined the UT staff as assistant trainer in 1970 and became head athletic trainer in 1978. He was instrumental in the passage of Natasha’s Law. • Theodore Spinks, MD - Dr. Spinks is the Chair of the Symposium Program Planning Committee. He is a Board Certified Neurosurgeon seeing patients in Austin, Round Rock, and Georgetown. He currently serves on the CDC Expert Panel for Pediatric Mild Traumatic Brain Injury, and served on the Texas Medical Association Committee on Concussions in Athletes during the last session of the Texas Legislature. • WHY: More than 3.8 million children are involved in organized sports in the United States. According to the Centers for Disease Control and Prevention:  • For males age 10-19 years, sports- and recreation-related Traumatic Brain Injuries (TBI) occurred most often while playing football or bicycling. • Females age 10-19 years sustained sports- and recreation-related TBIs most often while playing soccer or basketball or while bicycling. • WHO: Concussion Compliance, a community outreach project by Concussion Health, offers school superintendents, coaches, athletic trainers, primary care physicians, and parents a free online resource to increase the safety and care of student athletes while complying with state concussion laws. To learn more about the free compliance program and to view educational videos, go to concussioncompliance.com. • CONTACT: Theodore Spinks, MD, (512) 451-1969 • JesekaKreitner, (888) 313-4443 office, (512) 739-1811 cell, info@concussioncompliance.com • WEB SITE: www.concussioncompliance.com/symposium • SOCIAL www.facebook.com/concussioncompliance • MEDIA: • www.twitter.com/concussioncomp continued

3. Bridging the Gap on Best-Practices in Concussion Management A National Symposium Implementing Best Practices Putting the Pieces Together Austin, Texas Symposium Brochure Limited Seating – Register Today Saturday, March 2, 2013

4. Symposium Highlights This day – long program will encourage education and discussion – bringing together experts and practitioners – to help bridge the gap between what we know today as best available science and how to implement into best clinical practice, which is frequently the missing link in a comprehensive concussion management program. We have a number of world renowned concussion experts from a variety of disciplines presenting at this symposium. • Bridging the Gap on Best-Practices in Concussion Management • Saturday, March 2, 2013 • Featured Topics - The Physician’s Perspective; An Athletic Trainer’s Perspective; Head to Head: Cognitive Testing; Beyond Cognition: Balance Testing; A Look Into the Future: Vision Testing; Neurosurgical Management of Head Injuries and Concussion; Implementation of Best Practices Into Clinical Practice • Keynote Speaker – Dr. Steven Erickson will present on the latest guidelines for best practices in concussion management. Dr. Erickson is the medical consultant for Major League Baseball and serves on the Major League Baseball Medical Advisory Committee and the Major League Baseball Mild Traumatic Brain Injury Committee.   • Reading of Proclamation from Governor Perry’s Office – March Concussion Awareness Month in Texas • Exhibit Hall – Featuring the newest in technology, rehabilitation strategies, practice information, and pharmaceuticals

5. Program

6. Bridging the Gap on Best-Practices in Concussion ManagementA National Symposium Speaker/Moderator Information Jamie Schlueter, MD - University of Portland Dr. Schlueter is a medical doctor with a background as an athletic trainer in Austin, Texas. She is now an emergency room physician and a team physician for the University of Portland. Paul Saenz, DO - University of Texas at San Antonio Medical School, NBA San Antonio Spurs Dr. Saenz is board certified in both family practice and sports medicine and is an associate clinical professor at the University of Texas at San Antonio Medical School and the University of North Texas Health Science Center. He serves as a team physician for the NBA San Antonio Spurs, the WNBA Silver Stars, the San Antonio Missions Double A Baseball Club, San Antonio area high schools and universities. Shane Miller, MD - Sports Medicine Center at Children's Medical Center Dr. Miller is a pediatric sports medicine pediatrician at the Sports Medicine Center at Children's Medical Center in Dallas. The Sports Medicine Center at Children’s provides comprehensive care for young and growing athletes, including baseline and post-concussion neuropsychological testing. Michael Reardon, MD - Dell Children’s Concussion Center Dr. Reardon is a pediatric neurologist and medical director for the Dell Children’s Concussion Center. He is board certified by the American Board of Psychiatry and Neurology with a special qualification in Child Neurology. Spanky Stephens, ATC - Texas State Athletic Trainers’ Association Mr. Stephens currently serves as the TSATA Executive Director. Mr. Stephens was associated with UT athletics for more than 30 years. He joined the UT staff as assistant trainer in 1970 and became head trainer in 1978. He helped establish the strong student program that sent numerous qualified trainers into high school and college positions. Steven Erickson, MDKeynote Speaker - Major League Baseball Dr. Erickson is the fellowship director for the St. Joseph's Hospital and Medical Center. In 2000 he was hired as the head team physician at ASU and in 2003 he started the primary care sports medicine fellowship. Dr. Erickson serves as the medical consultant for Major League Baseball caring for the umpires and serves on the Major League Baseball Medical Advisory Committee and the Major League Baseball Mild Traumatic Brain Injury Committee.

7. Speaker/Moderator Information - continued Kenneth Locker, ATC - Presbyterian Hospital of Dallas Kenneth Locker is the director of sports marketing at Presbyterian Hospital of Dallas. Mr. Locker has cared for tens of thousands of North Texas athletes over the years and served as the athletic trainer for the Dallas Cowboys from 1973-1990. Rod Walters, DA, ATC An innovative professional, Rod Walters has enjoyed a storied career as a collegiate athletic trainer. Most recently, Mr. Walters has provided outstanding consultations and is a much-sought after public speaker through Walters Inc. – Consultants in Sports Medicine. Bucky Taylor, ATC An instrumental force in the passage of Natasha’s Law, Bucky Taylor served as head athletic trainer at Mesquite High School, Mesquite, Texas, for 36 years. Mr. Taylor now works as an itinerant trainer in Mesquite ISD and as a consultant to the Sports Medicine Clinic of North Texas in Dallas. Tina Bonci, ATC - The University of Texas Tina Bonci is co-director of the Division of Athletic Training/Sports Medicine for Intercollegiate Athletics at the University of Texas, Austin. She also continues to serve as an assistant athletic director for sports medicine in the Department of Intercollegiate Athletics for Women. Mike Lamb - Wells Fargo Insurance Services Mr. Lamb began his career in insurance nearly 20 years ago, following a college football career at the University of Southern California. In 2010 he was introduced to the Wells Fargo Insurance Services "Play it Safe Concussion Care Program" while searching for a viable concussion care program for his son's high school football team. Andrea Pana, MD - The University of Texas Dr. Pana is an associate team physician at The University of Texas with the primary responsibility for football. Prior to coming to UT in 2005, Dr. Pana was one of two team physicians for Purdue University where she cared for athletes of all sports as well as provided sports medicine care in the University Health Center. Rachel Mundy, RN – Pediatric Associates of Austin Rachel Mundy is a pediatric nurse practitioner at Sports Safe with Pediatric Associates of Austin. Ms. Mundy evaluates and manages pediatric and adolescent patients who have sustained a concussion.

8. Speaker/Moderator Information - continued Martha Pyron, MD - Medicine in Motion Dr. Pyron is board certified in both family medicine and sports medicine. After becoming board certified in both family medicine and sports medicine, she started her career as a team physician for Penn State University. She then returned to her home state of Texas and worked as a sports medicine specialist and team physician for the University of Texas at Austin. Richard Temple, PhD - Mind for Sports Dr. Temple is a clinical neuropsychologist and a board-certified sport psychologist through the American Board of Sport Psychology. Dr. Temple has worked in the field of brain injury rehabilitation for more than 10 years. He currently maintains a private practice in neuropsychology and sport psychology in Austin, where he provides concussion management, performance enhancement, and neuropsychological services. Louann Kuntz, ATC, PT, DPT, Med - Albany Medical Center’s Outpatient Physical Therapy Department Dr. Kuntz is currently the director of Albany Medical Center’s Outpatient Physical Therapy Department and Albany Med Fitness Center. She specializes in research-based physical therapy focusing on patient functional outcomes. Her areas of expertise span neurological, orthopedic, sports medicine, athletic training, and health services. James Kemper, MD - Austin Ear, Nose and Throat Clinic Dr. Kemper is board certified in otolaryngology and has 22 years of experience. He currently practices at Austin Ear, Nose and Throat Clinic. Anne Mucha, PT, DPT, MS, NCS - University of Pittsburgh An expert in the assessment and rehabilitation of balance, dizziness and visual symptoms following concussion, Anne Mucha coordinates the vestibular concussion program at the University of Pittsburg Centers for Rehab Services/UPMC Sports Concussion Program. In addition to her clinical practice, she is an adjunct instructor of physical therapy for the School of Health and Rehabilitation Sciences, University of Pittsburgh. Bridgett Wallace, PT, DPT - 360 Balance Bridgett Wallace, PT, DPT, is President of 360 Balance and brings more than 15 years’ experience to treating patients with dizziness and balance disorders. She holds a competency-based certification in vestibular rehabilitation and received her Doctorate of Physical Therapy from Texas State University.

9. Speaker/Moderator Information - continued Mary McMains, OD, MEd, FCOVD - Center of Vision Development Dr. McMains received her Doctorate of Optometry at Pacific University in Forest Grove, Oregon, and concurrently received her Master of Education in Visual Function in Learning in 2000.  Along with her didactic training, she was clinically trained by several world renowned doctors in her field to diagnose and treat the following populations:  vision related learning disabilities, infants and pediatrics, strabismus, amblyopia, developmental delays, AD(H)D, autism spectrum, acquired brain injury , vision-vestibular disorders, gifted/talented and athletes.  Jason Clopton, OD, FCOVD - Center of Vision Development Dr. Clopton is a pediatric optometrist at the Center of Vision Development (COVD), Cookeville, Tenn. Derek Hamilton, OD - Wells Branch Vision Care Dr. Hamilton graduated from Michigan College of Optometry in May of 2006. His professional interests include pediatric vision development and primary care optometry. Dr. Hamilton is actively involved in volunteering his optometric services in the South American country of Guyana. Emily Schottman, OD, FCOVD - Stars in Your Eyes Dr. Schottman has worked in the optometric industry since she was in high school, she has been licensed in Virginia, California and Texas. She graduated with honors from University of California, Santa Barbara and the Southern California College of Optometry. Dr. Schottman has a passion for Computer Eye Fatigue and specialty Pediatric cases. Theodore Spinks, MD - Spinks Neurosurgery Dr. Spinks is a board certified neurosurgeon seeing patients in Austin, Round Rock, and Georgetown, Texas. He currently serves on the CDC Expert Panel for Pediatric Mild Traumatic Brain Injury, and served on the Texas Medical Association Committee on Concussions in Athletes during the last session of the Texas Legislature. Mark Burnett, MD – St. David’s HealthCare As the Medical Director of the NeuroTexas Institute Research program, Dr. Burnett has been instrumental in developing the Center for Computational Neuroscience which focuses on the analysis of neurosurgical outcomes and development of novel treatment pathways to improve the care of neurosurgical patients. Douglas Fox, MD – St. David’s HealthCare Dr. Fox's clinical interests include cerebrovascular neurosurgery, skull base surgery, and complex spinal surgery. Dr. Fox has published widely and maintains an active research interest in cerebrovascular physiology and the development of new surgical technologies. 

10. General Information Overview This course focuses on an evidence-based and comprehensive team approach for concussion management. It provides an overview of the latest guidelines for best practices in concussion management, reflects on the impact of sports-related concussions and discusses the path physiology of a concussion for both adolescents and athletes. This course also places an emphasis on clinical indicators (both computerized and non-computerized) to guide healthcare providers in the evaluation and recovery process, which includes a closer look into balance and vision testing. More specific guidelines within the graded “step-wise” approach are provided for exceptional as well as the rationale for balance and eye-head coordination activities when indicated. The material is presented in a format to include lecture and discussion. Objectives Upon completion of this workshop, the participant will be able to: • Provide current definition of a concussion and recognize the impact of sports-related concussions • Implement an evidence-based approach to best practices for concussion management including the importance of a multi-disciplinary team approach • Implement a graded “step-wise” approach in the return –to-play process • Understand the rationale to integrate vision, vestibular and cognitive exercises into the return-to-play process • Identify the need for further testing and for specialty referrals when indicated Credit 7 Continuing Education Units  • This course has been approved by the Texas Physical Therapy Association as well as all other Physical Therapy Licensing Boards and state associations in the U.S. • This course has been approved by the National Athletic Trainers Association Board of Certification (BOC) • This course is awaiting approval for physicians, optometrists and other healthcare providers A record of attendance will be provided to all registrants for requesting credits in accordance with state nursing boards, specialty societies or other professional associations. Exhibits As of this printing, a complete listing of commercial supporters was not available. Appropriate acknowledgment will be given to all supporters at the meeting. Exhibits will be available for viewing at all scheduled breaks and lunch. Travel and Lodging Information Information regarding directions, hotel accommodations and transportation can be found on the symposium website www.concussioncompliance.com/symposium. Disclaimer Attendance at this course does not indicate nor guarantee competence or proficiency in the performance of any procedures which may be discussed or taught in this course.

11. OUR SPONSORS! Presenting Sponsor St. David’s HealthCare Principal Sponsors ReBuild Products Natus Medical Dell Children’s Medical Center of Central Texas Supporting Sponsors Balance Engineering Concussion Health Wells Fargo Insurance’s Play It Safe Concussion Care 360 Balance CORE Health Care Texas Brain Injury Alliance Stars in Your Eyes Neuro Resource Group NeuroImpact Biodex Medical Systems

12. Bridging the Gap on Best-Practices in Concussion Management A National Symposium Saturday, March 2, 2013 - Norris Conference Centers Fax this form to Concussion Compliance at 888-313-4443 REGISTRATIONFORM Option 1 – Register online: http://concussioncompliance.eventbrite.com Choose your Ticket Type, the number of tickets, and click Register Option 2 – Please email or fax your credit card information and completed registration form to: info@concussioncompliance.com Fax: 888-313-4443 Option 3 – Please mail your check and completed registration form to: Concussion Compliance 5608 Park crest Drive, Ste. 100 Austin TX 78731 CONTACT INFORMATION: __________________________________________ NAME (PLEASE PRINT) __________________________________________ TITLE __________________________________________ ADDRESS 1 __________________________________________ ADDRESS 2 __________________________________________ CITY/STATE/ZIP __________________________________________ EMAIL __________________________________________________ PHONE NO METHOD OF PAYMENT: Method of Payment: ______________________________________ NAME ON CARD (PLEASE PRINT) ______________________________________ CREDIT CARD BILLING ADDRESS (if different from above) ______________________________________ CITY/STATE/ZIP CHECK made payable to Concussion Compliance PURCHASE ORDER/CREDIT CARD AUTHORIZATION - THIS AUTHORIZES CONCUSSION COMPLIANCE TO CHARGE MY CREDIT CARD. VISA MASTERCARD DISCOVER AMERICAN EXPRESS _____________________________________ CREDIT CARD NUMBER _____________________________________ EXPIRATION DATE CVC X______________________________________

13. CONCUSSION FACT SHEET • Did you know? • Youth athletes are more susceptible to concussion and recover more slowly than collegiate or professional athletes. • Most sports- and recreation-related concussions seen in emergency rooms (65%) occur among youth ages 5-18 • One in 10 Athletes will suffer a concussion this year, according to research by the CDC. About 38 million boys & girls play organized sports. There are 3.8 million reported sports- and recreation-related concussions (Many more go unrecognized & unreported) • An athlete can still get a concussion if they are wearing a helmet • Concussions impair thinking and memory, and may also cause emotional or behavioral changes • It often takes time for signs and symptoms of a concussion to fully develop. • A single test that can rapidly and reliably detect a concussion and complete recovery from the head injury does not exist. • Concussions can occur in any sport through contact with players, equipment, or facilities. They occur most often at the high school level in football, soccer, lacrosse, wrestling, basketball, cheerleading, baseball, and ice hockey. • Recent literature reviews fail to support Loss of Consciousness as a predictor in either concussion severity or return-to-play timeframe. However amnesia or memory loss is an important clinical sign of concussion. • Concussion Definition • International experts: “a complex path physiological process affecting the brain, induced by traumatic biomechanical forces -- either a direct blow to the head, face or neck; or a blow elsewhere on the body with an ‘‘impulsive’’ force transmitted to the head.” • In other words, a concussion is a brain injury caused by traumatic force. • Concussion Signs & Symptoms • Cognitive - Amnesia, confusion, disorientation • Physical - Balance difficulty, vertigo, tinnitus, blurry vision, nausea • Emotional - Change in mood, anxiety, depression, agitation

14. Concussion Signs (Things we can observe) • Appears dazed or stunned • Confused about assignment • Unable to remember plays • Unsure of game, score, opponent • Slow to answer questions • Moves clumsily • Loses consciousness • Vomits • Shows behavior or personality changes • Concussion Symptoms (Athlete Complaints) • Headache • Nausea • Dizziness or balance problems • Double or fuzzy vision or any other visual alteration • Sensitivity to light and/or noise • Feeling sluggish or slow • Feeling “foggy” or groggy • Concentration or memory problems, confusion • Extreme fatigue • Best-Practice Recommendations • Use available tools for baseline testing in the pre-season • Access to a certified / knowledgeable healthcare provider who can provide a sideline evaluation • Insist on a “safety first” style of play • Make sure players wear approved and properly fitting protective equipment • Immediately remove an athlete from play if a concussion is suspected “When in doubt, sit them out” • Maintain policy of “no same day return to play” • Athletic trainers, parents, coaches, teachers & healthcare providers work together to support athlete • Athletes support & look out for each other • Parents seek appropriate medical care • Take time to recover -- follow healthcare provider’s guidelines on gradual increase in activity / play • Healthcare providers make return-to-play decision (follow state laws)