What is Sway?

Postville High School Athletics will be using a concussion management software called "SWAY".

Sway combines objective balance measures using accelerometers and sensors that are already built into your mobile device as well as cognitive measures to support healthcare professionals in performing accurate and informed evaluations using one’s own mobile device. Sway is available on both the Apple iOS and Android operating systems.

Balance: Sway measures stability using built-in motion sensors of any mobile device or tablet to quantify postural sway. While the device is pressed against the chest, a motion analysis algorithm calculates stability that allows healthcare professionals to administer a medical grade balance test in virtually any setting.

Cognitive: In addition to balance, Sway, collects key measurements in concussion management such as:

• Memory
• Reaction Time
• Impulse Control
• Inspection Time

Baseline Testing:

• A baseline measurement will need to be taken annually at the beginning of the sport season and/or after recovering from a known concussion.
• Group baseline testing will be conducted with each team at the beginning of the season, in-person at the school. You will not need to take a baseline test at home as you have in the past.
• Baseline testing will utilize each individual’s personal mobile device.
  • The mobile device must be able to run the Apple or Android operating systems and be able to download the Sway App.
    • It is helpful to download the Sway App prior to coming for a baseline session. Links to download the app can be found below.
  • If you do not own a smart mobile device or cannot download the Sway app, we will provide a means of baseline testing for you.
• Baseline testing will include 1 practice round and then 3 baseline measures, combining those scores for an accurate total measure of your balance and cognitive performance. Each test round takes about 5 minutes, 20-30 minutes total. A general baseline session would be as follows:
  • Symptoms checklist
  • Practice Round
  • Baseline 1
  • Baseline 2
  • Baseline 3
  • Complete

Why use a concussion management software?

1. It protects your safety – even from yourself. Sometimes athletes are surprised at how poorly they perform on this test after they have assumed they’re fine. Balance and cognitive testing allow us to see the invisible symptoms that can occur during a concussion.
2. Tracking – we can see how quickly you are recovering so you can return to play at the earliest safest time. We can also track if things aren’t going so well and identify ways in which we can assist your recovery.
3. Hard objective data – when in doubt, objective data can serve as another data point in identifying impairments and aid in the diagnosis of concussion or post-concussion symptoms.

What happens when a head injury is suspected?

According to ​the Iowa High School Athletic Association and Iowa Girls High School Athletic Union Guidelines: https://www.iahsaa.org/wp-content/uploads/2019/09/ConcussionManagementReturntoPlayGuidelines.pdf all athletes who are witnessed hitting their head and exhibit signs or symptoms of vestibular disturbance, cognitive impairment, head pain, or other systemic effect (like nausea or visual impairment) should be examined by a medical professional and assessed for a sports related concussion. Specific examples of symptoms and their presentation can be found here: https://www.iahsaa.org/wp-content/uploads/2019/09/ConcussionSymptomsCoachOfficialObservation.pdf

​What happens when my athlete is suspected of having a head injury at an PHS event?

If a head injury is suspected, the following scenarios are the general steps that should be expected to occur:

1. Athlete is immediately removed from play/participation.
2. Sideline evaluation takes place, this will be a comprehensive evaluation conducted by our Certified Athletic Trainer, Team Physician, and/or other appropriate healthcare provider appointed by the school. If athlete is off-site, or an appointed healthcare provider is not available for a sideline evaluation, the athlete will not return to participation and parents/guardians will be notified at the time of injury.
3. If sideline evaluation has occurred, the parents/guardians will be notified of the suspected head injury.
4. If a head injury is suspected the athlete may be referred to their primary care physician, neuropsychologist, or other relevant physician.
5. If a diagnosis of concussion is made, the provider can prescribe the athlete with modified academic requirements, modified physical restrictions, neither or both. That prescription is delivered to the School Nurse.
6. Before returning to activity, an athlete who has sustained a head injury must:
   1. Be symptom free.
   2. Cognitive and balance functions should return to or close to baseline/normative level.
   3. Returned to a normal cognitive/class work load and actively making up any missed work.
   4. Undergo a gradual return to play protocol monitored by the Certified Athletic Trainer or other appointed healthcare provider.
   5. An agreeance that the athlete is ready to return to activity between the:
      1. Athlete
      2. Coach
      3. Parents/Guardians
      4. Healthcare Provider (AT and/or Physician)
      5. Administration

Should you have any questions or concerns regarding our concussion management protocols, please reach out to our Certified Athletic Trainers or our Athletic Director.

For more information regarding the Sway software, please visit: https://swaymedical.com.

To download the Sway Application, please use the following links:

Apple iOS:

https://apps.apple.com/us/app/sway-medical/id657932025

Androind/Google Play:

https://play.google.com/store/apps/details?id=com.swaymedical.Sway

Phone Settings for Testing:

• Volume On
• Change brightness to full
• Change auto-lock/timeout settings.
  • Settings 🡪 Display & Brightness 🡪 Auto-lock 🡪 5 minutes
• Place phone on DND (do not disturb)
  • Note: Do not use airplane mode, this will prevent the data from being uploaded

Baseline Testing:

• Enter session code that will be provided for your baseline session.
• Set up your profile by entering your information, please use your school email.
• Run hardware verification
• Symptoms, if you are not experiencing listed symptoms, skip. Make sure to read them all and indicate if they do exist.
• If you click out of the screen or pull down your menu bar, the current test will be canceled and you will go back to the last completed screen (not a big deal, you’ll pick up where you left off).
• When measuring balance, make sure your feet are in the proper stance. (ex. Feet together or heel to toe)
• Keep both hands on the phone & use flicking action when measuring reaction time.