Misunderstandings of concussion within a youth rugby population

Kearney, Philip Edward; See, James

doi:10.1016/j.jsams.2017.04.019

Cited by 19 publications

(24 citation statements)

References 27 publications

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“…As in the present study, the Shuttleworth-Edwards [32] study found the most frequently reported symptoms to include headache, fatigue, balance problems, concentration, dizziness, light sensitivity and sleeping problems. These findings are in line with international research studies by Brooks et al; [2] Kearney et al; [4] Marar et al [33] and Green et al [34] which showed that at three months post injury, high school athletes were still reporting more symptoms of headache, dizziness and poor concentration compared with controls, illustrating prolonged effects in high school athletes. These persisting symptoms could have severe effects on an individual's daily activities, including ability to work and attend school, function independently at home, or develop and maintain appropriate social relations.…”

Section: Researchsupporting

confidence: 89%

Symptom profile following cumulative mild traumatic brain injury in early adolescent rugby union players in South Africa

Okusanya

Basson

2020

S Afr J CH

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This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Rugby is a popular sport in South Africa (SA), played by children from as young as seven years of age. [1] Rugby is classified as a high-impact and collision sport, which adds to its high potential for contact injury, such as mild traumatic brain injury (mTBI). [2] Young players are particularly vulnerable to sustaining mTBI, as the brain is not yet fully matured and therefore more vulnerable to the effects of the damage associated with brain injury. [3] The prevalence of mTBI in schoolboy rugby players has been cited to be as high as 50%. [4] Many of these injuries are often unrecognised and unreported as players may be likely to underreport symptoms to expedite return to play. [5] Research indicates that the younger brain is particularly vulnerable to short-and long-term effects of concussion and requires longer recovery time from symptoms, as the brain is not yet fully developed. [6] Impulse control and selfmonitoring of behaviour are particularly susceptible to the effects of concussion during this developmental stage. [7] While relatively few studies have been undertaken on the length of time for symptom recovery among rugby players, existing literature demonstrates that, in most cases, it is presumed that symptoms dissipate within 3-10 days. [8,9] However, children and adolescents may take longer to recover. [10] Symptoms that occur within three months of the incident are considered to be 'acute'; when persisting in excess of three months, symptoms are deemed to be 'chronic'. [11] Findings by De Kruijk et al. [12] revealed that 28% of players had not fully recovered six months post mTBI and were therefore considered to have 'chronic' symptoms. A small minority of individuals may experience effects from six months until three years post mTBI. [13,14] The effects of moderate to severe mTBI can be permanent, and one of the most feared long-term effects is dementia. [15,16] Neuropsychological functional impairments following mTBI include a variety of symptoms which may significantly affect physical, cognitive and emotional well-being. [17-21] Table 1 portrays these symptoms, of which headache, fatigue, drowsiness, nausea and sleep disturbances are among the most commonly reported symptoms following mTBI. Physical symptoms indicative of cranial nerve damage include nausea, dizziness, blurred vision, diplopia, sensitivity to light and noise, hearing loss, tinnitus, and diminished sense of taste or smell. [22,23] Cognitive symptoms include attention and concentration difficulties, confusion and feeling mentally 'foggy'. [24] Behavioural and emotional symptoms include apathy and affective disturbances such as agitation, aggression, anxiety, depression, irritability and feeling more emotional. [25] More severe injuries are regarded as 'red-flag' signs, and a longer recovery period is suggested. [17-21] Table 2 outlines the recognised red-flag signs indicating emergency situations which necessitate referral to an emergency unit. The ...

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Section: Researchsupporting

confidence: 89%

Symptom profile following cumulative mild traumatic brain injury in early adolescent rugby union players in South Africa

Okusanya

Basson

2020

S Afr J CH

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“…Reasons for players not seeking treatment for concussions (and thus not making a claim) may include lack of recognition of the injury by the injured player or their family or teammates, or a belief that the injury is of insufficient severity to require presentation to medical providers [34][35][36]. For injuries other than concussion, players can return to play when they or their guardians see fit, either in conjunction with or independent of medical advice.…”

Section: Concussion/brain Injurymentioning

confidence: 99%

Injury Risk in New Zealand Rugby Union: A Nationwide Study of Injury Insurance Claims from 2005 to 2017

2019

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Objectives The Accident Compensation Corporation is a compulsory, 24-h, no-fault personal injury insurance scheme in New Zealand. The purpose of this large-scale retrospective cohort study was to use Accident Compensation Corporation records to provide information about rugby injury epidemiology in New Zealand, with a focus on describing differences in risk by age and gender. Methods A total of 635,657 rugby injury claims were made to the Accident Compensation Corporation for players aged 5–40 years over the period 2005–2017. Information about player numbers and estimates of player exposure was obtained from New Zealand Rugby, the administrative organisation for rugby in New Zealand. Results Over three quarters of claims (76%) were for soft-tissue injuries, with 11% resulting from fractures or dislocations, 6.7% from lacerations, 3.1% from concussions and 2.0% from dental injuries. Body regions injured included shoulder (14%), knee (14%), wrist/hand (13%), neck/spine (13%), head/face (12%), leg (11%) and ankle (10%). The probability of a player making at least one injury claim in a season (expressed as a percentage) was calculated under the assumption that the incidence of claims follows a Poisson distribution. Players aged 5–6 years had a probability of making at least one claim per season of 1.0%, compared to 8.3% for players aged 7–12 years, 35% for age 13–17 years, 53% for age 18–20 years, 57% for age 21–30 years and 47% for age 31–40 years. The overall probability of making at least one claim per season across all age groups was 29%. The relative claim rate for adults (players aged 18 years and over) was 3.92 (90% confidence interval 3.90–3.94) times that of children. Ten percent of players were female, and they sustained 6% of the injuries. Overall, the relative claim rate for female players was 0.57 times that of male players (90% confidence interval 0.56–0.58). The relative claim rate of female to male players tended to increase with age. There were very few female players aged over 30 years; however, those who did play had higher claim rates than male players of the same age group (1.49; 90% confidence interval 1.45–1.53). Conclusions Injuries resulting from rugby are distributed across the body, and most of the claims are for soft-tissue injuries. Rates of injury increase rapidly through the teenage years until the early 20 s; for male players they then decrease until the mid-30 s. For female players, the injury rate does not decrease as players move into their 30 s. Combining Accident Compensation Corporation injury claim data with national player registration data provides useful information about the risks faced by New Zealand’s community rugby players, and the insights derived are used in the development of rugby injury prevention programme content.

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“…12,13 Important misunderstandings about concussion have been identified, for example, one study revealed that 80% of youth rugby players believed that there needed to be a direct hit to the head to sustain a concussion. 14 Despite the high prevalence of concussion in equestrian sports, little is known about concussion awareness in those engaging in activities involving horses.…”

Section: Introductionmentioning

confidence: 99%

Concussion knowledge, attitudes and behaviour in equestrian athletes

Theadom

Reid

Hardaker

et al. 2020

Journal of Science and Medicine in Sport

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Objective: To determine knowledge, attitudes and behaviour towards concussion in adult equestrian athletes. Design: Nationwide, cross-sectional, questionnaire. Methods: Participants were recruited via advertisements circulated through social media, community presentations and equestrian organisations. Participants were sent a web link to an online questionnaire previously designed for high school athletes and modified to ensure relevance to equestrian activities. The percentage of correct responses per item and a total knowledge score were calculated. Differences in concussion knowledge by age, sex, level of experience and previous history of concussion were explored using t-tests, 95% confidence intervals (CI) and effect sizes. Results: The questionnaire was completed by 1486 participants (Mean age = 39.1 ± 15.4). Knowledge of what concussion was, how to recognise it and key symptoms (except poor sleep) was high (>80%). In contrast, awareness of guidelines was moderate (56%) and inability of helmets to prevent concussion was low (12%). Significantly higher levels of knowledge of concussion were identified in females compared with males (t=-6.55 p < 0.001, 95%CI=-3.26 to-1.75). The majority (87%) of participants reported that a helmet should be replaced after a fall, yet 46% reported re-using a helmet following a hit to the head. Conclusions: Knowledge of and attitudes towards concussion were positive. However, there were knowledge gaps and discrepancies between some attitudes and behaviour on some aspects of concussion. Targeted campaigns to promote awareness of concussion and improve recognition and onward management are needed. Education related to equestrian activities such as helmet use and injury mechanisms is needed to change behaviour and minimise the risk of injury.

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Misunderstandings of concussion within a youth rugby population

Cited by 19 publications

References 27 publications

Symptom profile following cumulative mild traumatic brain injury in early adolescent rugby union players in South Africa

Symptom profile following cumulative mild traumatic brain injury in early adolescent rugby union players in South Africa

Injury Risk in New Zealand Rugby Union: A Nationwide Study of Injury Insurance Claims from 2005 to 2017

Concussion knowledge, attitudes and behaviour in equestrian athletes

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