Head impact exposure from match participation in women’s rugby league over one season of domestic competition

Abstract BACKGROUND Consensus on the definition of extant video signs of concussion have recently been proposed by representatives of international sporting codes for global consistency across professional leagues. OBJECTIVE To review the reliability of the proposed international consensus video signs of concussion in National Rugby League (NRL) head impact events (HIEs). METHODS The video signs of concussion were coded for every HIE during the 2019 NRL season. Coding was conducted blinded to the concussion status. Frequency, sensitivity, specificity, and a receiver operating characteristic curve were calculated. RESULTS There were 943 HIEs identified over the 2019 NRL season, of which 106 resulted in a diagnosed concussion. The most frequently observed video sign in concussed athletes was blank/vacant look (54%), which was also the most sensitive video sign (0.54, CI: 0.44-0.63), while the most specific was tonic posturing (0.99, CI: 0.99-1.00). In 43.4% of diagnosed concussions none of the 6 video signs were present. The 6 video signs demonstrated a “fair” ability to discriminate between concussion and nonconcussion HIEs (area under the curve = 0.76). CONCLUSION International consensus agreement between collision sports for extant video signs of concussion and the definition of those extant video signs are clinically important. The selection of signs requires rigorous assessment to examine their predictive value across all sports and within individual sports, and to determine further video signs to compliment and improve the identification of possible concussion events within various sports. The current study demonstrated that, for NRL-related HIEs, the diagnostic accuracy of video signs varies.

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Examining Whether Onfield Motor Incoordination Is Associated With Worse Performance on the SCAT5 and Slower Clinical Recovery Following Concussion

Frontiers in Neurology ◽

10.3389/fneur.2020.620872 ◽

2021 ◽

Vol 11 ◽

Author(s):

Grant L. Iverson ◽

Ryan Van Patten ◽

Andrew J. Gardner

Keyword(s):

Assessment Tool ◽

Rugby League ◽

Head Impact ◽

Balance Performance ◽

Balance Test ◽

Video Footage ◽

Motor Incoordination ◽

Medical Clearance ◽

Impact Events ◽

Balance Problems

Objective: To examine the relationship between video-identified onfield motor incoordination, the acute assessment of concussion, and recovery time during three seasons of National Rugby League (NRL) play.Methods: Blows to the head (“head impact events”) were recorded by sideline video operators and medical staff. Any player with a suspected concussion underwent a Head Injury Assessment in which he was taken off the field and medically evaluated, including the administration of the Sports Concussion Assessment Tool, 5th Edition (SCAT5). Video footage was later examined to determine the presence or absence of onfield motor incoordination following the head impact event.Results: Motor incoordination was identified in 100/1,706 head impact events (5.9%); 65 of the 100 instances of motor incoordination (65.0%) were ultimately medically diagnosed with a concussion. In 646 athletes for whom SCAT5 data were available, those with motor incoordination were more likely to report both dizziness and balance problems than those without motor incoordination, but there were no group differences on an objective balance test. Additionally, there was no relationship between presence/absence of motor incoordination and number of games missed or time to medical clearance for match play.Conclusion: In NRL players, motor incoordination is a readily observable onfield sign that is strongly associated with a medical diagnosis of concussion and with self-reported dizziness/balance problems. However, onfield motor incoordination is not associated with objective balance performance and it is not predictive of time to recover following concussion.

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