Acute and Subacute Clinical Markers After Sport-Related Concussion

ObjectiveThis study aimed to determine the association of a range of off-field symptoms reported by athletes retrospectively with on-field concussion signs and in-office symptoms among rugby union players.BackgroundPlayers with sports concussion experience multiple symptoms. Understanding the association between these symptoms and clinical markers of concussion would facilitate a targeted approach to symptom assessment and treatment.Design/MethodsCross-sectional study. We consecutively enrolled 92 adult rugby union players, within the first 72 hours after sport concussion. Ten symptoms assessed using a retrospective symptoms interview were examined for their association with observed concussion signs and post-concussion symptoms using the Post-Concussion Symptoms Scale (PCSS).ResultsOdds ratios revealed that athletes who was overtly symptomatic based on retrospective concussion interview at the time of the concussion were over 2.6 times more likely (p = 0.047) to have exhibited post-traumatic amnesia when compared with athletes who was asymptomatic. There were no differences between groups in terms of on-field loss of consciousness or confusion. Off-field symptoms reported by athlete were associated with symptoms reporting on the Beck Depression Inventory (OR 2.8; 95% CI 1.14–6.88), headache (OR 4.9; 95% CI 1.92–12.79), memory concerns (OR 3.15; 95% CI 1.06–9.34), pressure in head (OR 2.8; 95% CI 1.03–8.08), and visual disturbances (OR 3.9; 95% CI 1.05–14.50) within the first 72 hours after concussion.ConclusionsSymptomatic concussed rugby athletes have increased odds for sustaining on-field concussion signs that can be observed by others and persistent symptoms within the first 72 hours after concussion. Information from the on-field and off-field assessment is essential in understanding the severity of sports concussion.

Wearables in rugby union: A protocol for multimodal digital sports-related concussion assessment

Background Pragmatic challenges remain in the monitoring and return to play (RTP) decisions following suspected Sports Related Concussion (SRC). Reliance on traditional approaches (pen and paper) means players readiness for RTP is often based on self-reported symptom recognition as a marker for full physiological recovery. Non-digital approaches also limit opportunity for robust data analysis which may hinder understanding of the interconnected nature and relationships in deficit recovery. Digital approaches may provide more objectivity to measure and monitor impairments in SRC. Crucially, there is dearth of protocols for SRC assessment and digital devices have yet to be tested concurrently (multimodal) in SRC rugby union assessment. Here we propose a multimodal protocol for digital assessment in SRC, which could be used to enhance traditional sports concussion assessment approaches. Methods We aim to use a repeated measures observational study utilising a battery of multimodal assessment tools (symptom, cognitive, visual, motor). We aim to recruit 200 rugby players (male n≈100 and female n≈100) from University Rugby Union teams and local amateur rugby clubs in the North East of England. The multimodal battery assessment used in this study will compare metrics between digital methods and against traditional assessment. Conclusion This paper outlines a protocol for a multimodal approach for the use of digital technologies to augment traditional approaches to SRC, which may better inform RTP in rugby union. Findings may shed light on new ways of working with digital tools in SRC. Multimodal approaches may enhance understanding of the interconnected nature of impairments and provide insightful, more objective assessment and RTP in SRC. Clinical trial registration NCT04938570. https://clinicaltrials.gov/ct2/results?cond=NCT04938570&term=&cntry=&state=&city=&dist=

Influence of Physical and Technical Aspects on Change of Direction Performance of Rugby Players: An Exploratory Study

We examined the relationships between change of direction (COD) speed and deficit, and a series of speed- and power-related measurements in national team rugby union players and analyzed the influence of movement patterns on COD ability. Eleven male athletes completed the following physical assessments on different days: day 1—anthropometric measurements, and lower-body kinematic parameters (assessed with eight inertial sensors) and completion time in COD tests (pro-agility, 45° cutting maneuver (CUT), and “L” (L-Drill)); day 2—bilateral and unilateral squat and countermovement jumps, 40 m linear sprint, and bar-power output in the jump squat and half-squat exercises. Pearson’s product–moment correlations were performed to determine the relationships between COD velocities, COD deficits, and the speed–power variables. Differences between players with higher and lower COD deficits were examined using magnitude-based inferences. Results showed that (1) greater sprint momentum was associated with higher COD deficits, particularly in drills with sharper angles and multiple directional changes (L-drill and pro-agility); (2) higher unilateral jump heights were associated with greater COD deficits in the pro-agility and L-drill but not in the CUT; (3) faster athletes were less efficient at changing direction and presented greater trunk and knee flexion angles during COD maneuvers, probably as a consequence of higher inertia.

Barriers, Attitudes, and Influences Towards Dietary Intake Amongst Elite Rugby Union Players

Background: Dietary intakes can impact an athletes health and performance. Although evidence exists about what an athlete should eat, an athlete's nutritional intake is influenced by many factors. The limited research available suggests the main barriers preventing optimal nutritional intakes reported by athletes are lack of time, food accessibility, poor cooking skills, costs, taste, and time spent in “off-season.” Although these factors have been shown to influence dietary intake they remain relatively unexplored in Rugby Union. This study aimed to describe the nutritional influences on dietary intake amongst Rugby Union player's.Methods: This was a qualitative study utilising in person individual interviews with all participants. Participants were Rugby Union players (n = 30) for either a Super Rugby franchise or one of their development squads in New Zealand. Participant's undertook recorded face to face interviews, which were later transcribed. A thematic approach was used to code the transcripts by the primary coder and the themes were subsequently evaluated by the research team.Results: Childhood upbringing, organisational skills, time and food security also emerged as barriers. Body composition and sport nutrition knowledge emerged as both barriers and enablers to nutritional intake. Influence on performance was an enabler to optimal dietary intake. Fully professional rugby players have access to dietitians, whereas development and semi-professional rugby players only have limited if any access, and they were more likely to seek nutritional information via social media.Conclusion: This study suggests a need for greater nutrition education at developmental levels with an emphasis on affordable food choices, meal planning and skills for interpreting online nutrition information.