Situational factors associated with concussion in cricket identified from video analysis

Abstract

Video analysis of situational factors associated with head impacts and concussion has been completed in several sports, however has yet to be completed in cricket. This study aimed to identify situational factors associated with concussion in elite Australian male and female cricket. Match video of head impacts were coded for player position, impacting object, source of ball, location of impact, and where the ball went after impact. Head impacts were then categorised as either concussion or no concussion based on clinical diagnosis. Data for 197 head impacts included 35 (18%) which were diagnosed as concussion. Head impacts typically occurred to an on-strike batter facing a pace bowler (84%). If the ball stopped or rebounded towards the source, 21% were diagnosed as concussion (13% if the ball deflected away from the source). If impact was to an unprotected head, 38% were diagnosed as concussion (16% if impact was to a helmet). If impact was to the back of the helmet or head, 40% were diagnosed as concussion (11–21% for other areas of the head or helmet). The combination of situational factors most consistent with concussion were impact from ball that hit the back of helmet or head and stopped or rebounded towards the source (PPV 80%, p = 0.002). Consideration of the situational factors of a head impact may improve the speed and accuracy of clinical decision making on whether to remove a player from the field for further assessment, particularly if clinical signs are unclear. Video may be used as a tool to support this process. Improved impact attenuation of cricket helmets, particularly at the back, may reduce the risk of concussion.

Observable player behaviours and playing performance following helmet strikes in elite cricket

“…Therefore, travel into the green zone on the frontal view may in fact appear in the red zone in the sagittal view, suggesting diagnosis could be improved with access to multiple angles. This is supported by the findings of Saw et al 24 who conducted a similar exercise in Australian cricket and demonstrated that the rebound of the ball towards the source or the ball stopping dead was associated with a higher risk of concussion. Standardisation of the views and reference frame in future may assist in investigating this further.…”

“…[21][22][23] In cricket, where the bowling line is permitted to contact the batsman who must react, impacts to the front of the helmet may result from a faster ball speed while a slower ball on a similar trajectory may prompt a player to turn their head in preparation for an impact. However, this relationship is clearly complex, as demonstrated by Saw et al, 24 who's work highlighted that impacts to the back of the helmet carried the highest positive predictive value of concussion.…”

“…This also raises a question about whether neck strengthening interventions may be beneficial for primary prevention. 24 25 …”

Prevalence and incidence of injuries among female cricket players: a systematic review and meta-analysis

“…Injury incidence was 24.8%8 to 28.9% 2 for fast bowlers and 5.9% 8 to 8% 2 for slow bowlers. Injury incidence for batting was 10.1% 37 to 57.9% 40 . Injury incidence for all-rounders who bowl and bat was 38.5% 8 to 41.2% 37 .…”

“…Medical-attention injuries were reported in seven studies 2,3,30,36,37,40,41 . Medical-attention injuries accounted for 100% of all injuries sustained in five studies 2,3,37,40,41 .…”