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Latest concussion study casts doubt over testing

Former rugby league star Ian Roberts has struggled in later life after taking head knocks as a player. (AAP Image/Mick Tsikas)
Roar Rookie
1st October, 2014
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As Sunday’s NRL grand final looms large, a Melbourne neuroscientist has issued a poignant reminder of the dangers of concussion across the football codes.

Dr Alan Pearce, of Deakin University, is the man whose research unveiled the plight of former league stars Shaun Valentine and Ian Roberts, as well as AFL hardman Greg ‘Diesel’ Williams.

Dr Pearce has published a new study reaffirming the prolonged impact traumatic injury may wreak on the brain.

Using cheat-proof brain stimulation testing, in conjunction with a battery of psychological assessments, Pearce monitored the recovery of 40 amateur Australian Rules footballers over the course of a season.

A Deakin statement to be released on Thursday confirms the eight players concussed during the season were tested at 48 hours, 96 hours and 10 days respectively after their injury, while other players were tested three times over a two-week period at the end of the season.

The recovering players, Pearce found, displayed “abnormal motor control, mental ability and brain activity” lasting up to 10 days post-concussion.

Their fine movement skills, memory, attention span and reaction time were below-par, in some cases for more than a week after their injury.

“This suggests that the underlying injury to the brain can take some time to mend and may still be present after the visible symptoms have passed,” said the neuroscientist.

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“Current testing measures will not pick up the actual impact to the brain so there is a need to review the testing regime to ensure that concussed players do not return to the field before the brain has had time to fully recover.”

While acknowledging the more proactive stance adopted by peak sports bodies, enhanced in part by the revelations and subsequent media storm generated by his own research, Pearce fears current testing methods may fall short of upholding player welfare.

“It is pleasing to see NRL officials reminding clubs to adhere to the league’s concussion policy during the grand final and these policies do go some way to ensuring player safety,” he added.

“We now know that the brain can take up to 10 days or longer to recover from the impact of a concussion.

“From the grassroots through to the professional level, multiple modes of testing over more than five days are therefore needed to assess a player’s recovery from sports related concussion.

“The brain simulation tests we used in this latest study are one addition that will provide a more reliable understanding of the impact on brain function and allow a better informed judgement of when a player is fit to return to play.

“While my study has focused on AFL, ensuring the most accurate testing possible is essential to ensure long term brain health regardless of the sporting code.

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“At the elite level, medical doctors use the sports concussion assessment tool version 3 (SCAT3) followed up by computerised mental testing programs and/or graded exercise testing to see if the player develops symptoms of concussion,” Pearce continued.

“With the graded testing, players who have had a concussion attend training after a day or two of rest and run around the ground at increasing intensities. If they do not develop a headache or dizziness during the increased exercise bout, they are considered fit enough to resume training and to compete.

“At the amateur level concussion monitoring is ad-hoc with some clubs enforcing a rest policy, but the majority of clubs allowing players to continue training and playing if they show no obvious symptoms.”

Pearce is confident that the brain stimulation technique he and his team employed will prove an important tool in the future of sports concussion management.

“What was novel about our testing approach was the use of transcranial magnetic stimulation (TMS), a safe and painless way of delivering electromagnetic pulses into select areas of the brain, to get a true measure of the changes in brain activity occurring,” he said.

“Using TMS enabled us to quantify the level of changes to brain activity more accurately than the desktop computer tests used.”

The results of Dr Pearce’s study, ‘Acute motor, neurocognitive and neurophysiological change following concussion injury in Australian amateur football. A prospective multimodal investigation’, will be published in an upcoming edition of the Journal of Science and Medicine in Sport. It is currently available online.

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