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.
“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.
“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.
Tom
Guest
I think the major issue that got the NFL done in was that they actually had pretty conclusive evidence that even the sub-concussive head traumas suffered by the players quite often (for example linemen who butt heads at every play) were likely to lead to chronic traumatic encephalopathy and its associated symptoms, however, they ignored and in some cases actively suppressed studies showing this.
AdelaideWill
Guest
The real issue is park football players without doctors and SCAT3 tests. Its the player that gets a heavy head knock and plays on, has a beer after the game and drives home that is scary. They need grass roots clubs to take some ownership and tell a player to come off if the injury is bad.
AdelaideWill
Guest
But what about the players in the leagues below the NRL? The issue isn't a NRL player on $500k getting a head knock its the plumber playing park footy for fun on the weekend week after week that has issues.
up in the north
Guest
I am not going to denigrate the validity and importance of this method, I will pose the question of what will it take to make the game safe. My guess is that nothing 'could' be done. It is -like all contact sport- inherently risky. Try to do a risk assesment and you'd find that there is no way to minimise risk, apart from changing the whole fibre of the game. Make people sign waivers and get on with it, or get a real job.
ranga
Guest
No football code will be untouched, in soccer they'll be looking at the impact of heading the ball especially at a young age when brain development is crucial in children.
Midfielder
Guest
As we move forward more studies will be carried out resulting in systems and procedures changing as new knowledge and understanding becomes available.. The smoking gun is the legal system will Salter & Gordon undertake a class action against the codes ... is this covered by insurance .. The contact codes in particular could have a firm like Salter & Gordon already making phone calls... Huge question for which I have no idea is could a player from the 70's / 80's as an example make a claim when at the time they were playing no such knowledge was known... The Gridiron players were successful ... tis a smoking gun is this an issue and can it be proven..
mushi
Guest
Yep it sounded like he's saying he's developed a better system that should be used rather than the NRL has a horrible one by current standards.
Jacob
Guest
“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" Yeah we have all seen some clubs in the NRL pay lip service to this rule during the year...
seajay23
Guest
So it may be that a mandatory two week break following a concussion will be the next stage. As long as it is applied consistently it can only be a good outcome, but somehow the decision needs to be taken out of the hands of the club and players. Perhaps an indepedent medical panel to review all concussions with a clearance required before a player can return to training and playing is the way to go. It would be administratively difficult and costly but justifiable both in terms of player safety and reduced compensation payments in the future. Such a panel could cover all codes and grades, that would share the costs and increase the independence of the decision makers.
Fairy fairfax
Roar Rookie
It appears that Dr Pearce has identified a more comprehensive method of testing. This can only be a good thing inasmuch as a player suffering non-apparent symptoms can get further along the road to recovery. I would like to read his report to see if his diagnostics can identify if any of the damage is permanent to the nerves or blood vessels.
Chris morrison
Guest
Totally agree Barry. The NRL are doing what they can to promote player welfare and safety, with the technology and procedures that they have in place. Now that there is further advancements available in this, I'm sure that we will see the NRL implement these.
The Barry
Roar Guru
It didn't sound like Dr Pearce was casting doubts over the testing to me? Sounded like he was saying the tests and protocols were positive. New information about this will continue to come out all the time. We can't keep rubbishing what's been put in place in a relatively short period of time. Because there is new information. If there are new and better tests that need to be used great. But it can't be reported as "concussion protocols are no good"