Technology largely used in stroke care is emerging as a tool to see athletes with neurologic injuries related to sports, leading to a faster safe return to play.

With a combination of cameras, microphones, and a secure internet connection, UConn Health neurologists can evaluate athletes remotely – daily if necessary – to monitor their recovery in tandem with their onsite providers.

It’s known as teleneurology, a form of telemedicine specific to neurology, and its utility in sports medicine, particularly related to concussions, is relatively uncommon. UConn Health started offering it in 2016, shortly after Dr. Anthony Alessi established UConn Health’s NeuroSport practice in Storrs.

“We look at professional, collegiate, and high school athletes, all levels,” Alessi says. “Where it really helps is with students. You avoid students missing time in class and having to travel a long distance, and they’re getting more frequent follow-up and direction on their care. We’re trying to get them back as quickly as we can, without having to wait for an appointment.”

Often this patient video conference – which is encrypted to comply with patient privacy regulations – involves an athletic trainer, nurse practitioner, or another physician at the patient’s side to assist with the examination. This enables Alessi to have a dialogue with both patient and provider, all while having eyes on the athlete.

It’s a resource that’s proven particularly effective for teen athletes.

“Being a teenager is a risk factor for concussion in and of itself,” says Kendra Wiesel, director of health services at Loomis Chaffee, a private high school in Windsor. “Students are exposed to physical activity on a regular basis, and level of competition is elevated. They also have busy social and academic schedules, and their brains are still developing. Recovering from a concussion can be difficult for so many reasons for this demographic.”

As part of its concussion recovery program, Loomis Chaffee started using teleneurology consultations with Alessi in the spring, providing follow-up care for a student athlete who also was a UConn Health patient.

“We were able to ensure a safe return to athletics and academics for the student by combining daily in-person visits in our health center with Skype sessions with Dr. Alessi,” Wiesel says. “The landscape is continually changing when it comes to this field. It is so important to have access to specialists like Dr. Alessi. Telemedicine is an exciting development that we are looking forward to integrating into our program.”

Teleneurology is one piece of a growing sports neurology discipline at UConn. Alessi provides consultative care to all levels of the New York Yankees organization, including in the Dominican Republic, and NeuroSport has formed an alliance with the Western Sports Foundation to provide care for professional bull riders.

A typical encounter with a bull rider would involve the athlete flying to Connecticut to meet with Alessi and a physical therapist and undergo an MRI and a neuropsychometric testing, which can provide insight into attention span, concentration, cognition, memory, motor function, perception, decision-making, and speech. Once the results are in, usually three weeks later, another evaluation follows.

When the program first started, riders were reluctant to participate out of fear they would be told they’d have to quit riding, but Alessi says, “What happened instead with some of the earlier riders is, we were able to incorporate things into their regimen that not only didn’t tell them to stop riding, but improved their performance.”

What an athlete may fear is a chronic brain trauma injury could turn out to be something entirely different, and treatable, such as a migraine, a sleep disorder, or a previously undiscovered learning disability.

“What we’re finding is that, as much as we are finding people who have brain damage and we need to explain to them that they need to leave their sport, the majority of the people we’re seeing are people who we’ve been able to improve their performance, and their life,” Alessi says.