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Concussion Pilot Study

Concussion Pilot Study

A pilot study to assess the effects of concussion on adolescent Rugby Union players and the development of a concussion passport.

 

Awareness of concussion symptoms can improve diagnosis and treatment.

 
Sports Surgery Clinic in conjunction with 5 Dublin schools, Blackrock College, St. Michael’s College, St. Andrew’s College, Gonzaga College and St. Mary’s College will screen 200 schoolboy rugby players in pre-season 2016- 2017 for symptoms of concussion using the atest evidence-based tests and markers.
 
Throughout the season, those players who suffer a concussive event will have immediate access and follow-up to monitor their symptoms and will follow a rehabilitation protocol to return to full sport under appropriate guidelines and medical care.

Research helps to make our players safer

 
By collecting this data, we can help to change the landscape of concussion management, improving our understanding of the condition and how to treat it.
 
A Concussion Passport will give you access to invaluable information about your concussion injury history throughout your sporting career.
 
For further information on this please contact us on 01 5262030 or sportsmedicine@sportssurgeryclinic.com
 

Pre-Season

 
With your parents’ consent, you will be invited to attend the Sports Surgery Clinic to complete a pre-season screening session.
 
The assessment will take up to three hours and will be conducted by highly experienced medical staff who will take every measure to ensure your safety and health during testing.
Online questionnaire: This will be undertaken in pre-season. You will be asked to answer questions about your medical history, previous injuries and playing history e.g. what sports you play, what sports you play, what level you play at and how long you have played for. We will also ask about your sleep and mood. These questions allow us to get a picture of your normal day to day behaviour and what conditions you may have had or currently have as you join the study
 
 

In-Season

 
If you are suspected of having a concussion, a minimum of two medical assessments will be required during the recovery period (i.e. the initial concussion assessment and the medical clearance to return to play).
 
Participants will be asked to attend SSC Concussion Clinic where postinjury assessment will take place.
 
Following each assessment, you will be provided with a written report on the day of testing. Although, an individualised rehabilitation programme will be given based on the findings of these tests, athletes diagnosed with a concussion will adhere to the IRFU guidelines and will not return to play before the ecommended 23 days.

Axon Sports Test

 
This test is a computerised brain health assessment. It measures reaction time, learning and memory skills, attention, concentration and problem solving capacity. Concussion has been shown to leave players with deficits in these types of brain activities. It is important to test these qualities before the season begins so we have baseline results to compare to at a later stage.
 

King-Devick Test

 
This test will take two-minutes to complete. You will be required to read single digit numbers displayed on a screen. It measures the speed and accuracy of your eye movements. Research has shown that impaired eye movement, poor attention and difficulty with language can be identified using this test, indicating suboptimal brain function. It is a useful pre-season test to establish your normal ability.
 
Immediately or soon after a suspected head trauma, you will be asked to complete the King–Devick Test again. The doctor or researcher will be assessing whether the time to complete the test is longer than your baseline test time and/or if there are errors.

Balance Assessment

 
Balance testing is a way for doctors to assess how well the part of the brain that controls movement is functioning. You will be asked to complete several balance tests in pre-season and if there is a suspected concussion.
 
You will be assessed standing on two legs, standing on one leg and standing heel to toe. Testers will assess for errors of movement and body sway during this test.
Another test will require the use of more sophisticated force plate technology.
Force plates can measure how much a person sways when standing in certain positions. Studies have shown that patients with sports concussions tend to sway more than healthy persons up to 30 days after injury, depending on the severity of injury.
 

Exercise Challenge Test

 
Exercising can exacerbate symptoms of concussion. Testers will observe your body’s ability to regulate your heart rate, your blood pressure and monitor your symptoms of concussion while you exercise on a treadmill.
 
International return to play guidelines recommend that athletes should be able to exercise maximally without symptoms before they are allowed to return to play.
 

Blood Test

 
Blood will be taken to measure some baseline markers of concussion and again if there is a diagnosed concussion. Providing you are happy, the blood will be stored to allow us to analyse the sample at a later date as our knowledge of concussion improves
and new techniques such as genetic testing are discovered.
 
Blood that is stored will be marked with acode and remain anonymous and we will not be able to relate the sample back to you.
 
Researchers will be checking to see if recovery time post concussion is different in those who carry a specific gene compared to those who do not.
 
Blood samples will be destroyed after 24months.
 

ICS Impulse Test

 
ICS Impulse goggles allow assessment of vestibular and oculomotor deficiencies with greater accuracy allowing faster diagnosis.
A high-speed camera, light weight and built in calibration lasers,help to provide feedback quickly. It has multiple functions allowing it to assess your inner ear system, you vision system, your eye control and helps to provide clear data that can be interpreted by the clinician at SSC.

Activity & Sleep Monioring

 
Each participant who suffers a concussion will be given a Fitbit Activity Monitor to sense user movement. This sensor tracks steps taken and combines it with user data to calculate distance walked, calories burned, floors climbed and activity duration and intensity.
 
It also measures sleep quality by tracking periods of restlessness, how long it takes the wearer to fall asleep and how long they are actually asleep.
The data collected will be downloaded at each subsequent visit to SSC.
 
 

What is Concussion?

Concussion is a traumatic injury to the brain. It is an injury most often associated with athletes who play contact sport, such as Rugby Union. Concussion commonly results from a direct or an indirect blow to the head. It is a complex process in which forces are transmitted to the brain and results in temporary impairment of brain function.
 
Common symptoms of a concussion include headaches, confusion, dizziness, nausea and vomiting.
 

Will it cost anything to participate in the study?

No cost will incur to participate in this study.

What is the objective of the study?

This study aims to develop a framework to identify schoolboy rugby athletes who have sustained a concussion and safely manage their condition, not only up to the point of return to sport but throughout their sporting career.

Are there any risks associated with participating in this study?

The Buffalo Challenge Test is performed on an exercise treadmill. There is a very small risk of a fall on the treadmill. All tests will be performed by medical staff trained in CPR with access to full resuscitation equipment as per SSC protocol.

Can I withdraw from the study if I change my mind?

Participants are free to withdraw from the study at any time without penalty.
 

Will information be kept private?

All participants’ information will be completely private. You will be assigned a specific number for testing that will be maintained throughout the research programme to ensure that personal data is secure and confidential.
 

What is the potential benefit that may occur as a result of this study?

While there is no direct benefit to participants, those who suffer a concussion will follow an enhanced recovery and rehabilitation programme managed by the Sports Medicine Consultant Physician at no direct cost to the participant.
 
The information from the study will help create a framework for the safe management of schoolboy rugby athletes post-concussion and to develop a Concussion Passport that can be used to track athletes through their careers.
Participation in this study will involve a pre-season screening at the Sports Surgery Clinic (SSC ) comprising of:
  • Online questionnaire including concussion symptoms scales
  • Computer cognition assessment
  • Balance assessment
  • Eye movement and control assessment
  • Blood test
  • Assessment of your vestibular function
  • Activity and sleep monitoring
  • Exercise Challenge test
  • Daily online wellness measurement and symptom profile
 
If you sustain a concussion, you will be asked to attend SSC’s Concussion Clinic where the post injury assessment protocol (as above) will be followed by an assessment by the Sports Medicine Consultant Physician and where necessary, referral to the neurologist.
 
All participants will be given a written report on the day of assessment for their parents, themselves and their GPs.
Following their assessment, the athletes will be provided with an individualised rehabilitation programme involving return to school advice followed by a graduated return to learn and ultimately return to sport programme.
 
It is expected that a minimum of two medical assessments by Sports Medicine Consultant Physician will be required during the recovery period (the initial assessment and the pre-return to play assessment) and where necessary some of the tests will need to be repeated.
 

Eanna Falvey

Director of Sports & Exercise Medicine

Speciality: Sports & Exercise Medicine Physicians
Suite: Sports Medicine
Phone: 01 526 2030
Fax: 01 526 2046
Mon
Tue
Wed
Thu
Fri
Sat
Sun
09.00 - 18.30

Andy Franklyn-Miller

Director of Rehabilitation & Research

Speciality: Sports & Exercise Medicine Physicians
Suite: Sports Medicine
Phone: 01 526 2030
Fax: 01 526 2046
Mon
Tue
Wed
Thu
Fri
Sat
Sun
09.00 - 18.30

Ciaran Cosgrave

Sports & Exercise Medicine Physician

Speciality: Sports & Exercise Medicine Physicians
Suite: Sports Medicine
Phone: 01 526 2030
Fax: 01 526 2046
Mon
Tue
Wed
Thu
Fri
Sat
Sun
09.00-18.30

Cliff Beirne

Consultant Maxillofacial Surgeon

Speciality: Maxillofacial
Suite: 12
Phone: 01 526 2275
Fax: 01 526 2279
Secretary: Gillian Butler
Mon
Tue
Wed
Thu
Fri
Sat
Sun

Colm Fuller

Lead Musculoskeletal Physiotherapist

Speciality:
Suite: Physiotherapy
Phone: 01 5262040
Fax: 01 5262048
Mon
Tue
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Thu
Fri
Sat
Sun
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