The recovery patterns of sport concussion among youth are being investigated by Massey University researchers.
The researchers noted that experts in the area had largely focused on American football, soccer and rugby, with equestrian pursuits being somewhat ignored.
However, the high prevalence of concussion in equestrian sport was recognized at the most recent Concussion in Sport conference, and as a result the FEI will be developing concussion guidelines specific to equestrian pursuits.
Concussion in sport is a serious injury that can have long-term consequences on intellect, especially for youth whose brains are still developing.
Studies indicate neuropsychological testing is effective in detecting the subtle impairments in intellect following a concussion, even when the individual may feel fine.
A doctoral student, Shannon Martin, and her supervisor, Dr Clifford van Ommen, a registered clinical psychologist and director of the Centre for Psychology at Massey University, are offering free cognitive assessment of concussion for individuals aged 12 to 19.
Participants will complete a 30-minute computerized American-developed ImPACT test in Albany Village, on Auckland’s North Shore, that measures cognitive domains known to be affected by concussion. These include memory, attention, and processing speed.
Individuals will complete the test as soon as possible to provide a baseline measure of their cognitive performance. Participant cannot have been concussed within the previous month.
If they sustain a concussion during 2013 they can be retested periodically until their concussive symptoms resolve. Any post-concussion performance that deviates from their baseline performance provides valuable information to doctors, coaches, and parents regarding their recovery from concussion and thus helping to inform when it is safe for them to return to riding.
The research aims to assess whether the American-developed ImPACT measure is appropriate to use with New Zealanders. It will also look to develop New Zealand norms and, among rugby players, assess whether the current three-week stand-down period recommended by New Zealand Rugby Union is long enough for adolescents to recover from concussion.
Martin and van Ommen also want to assess whether neuropsychological tests provide valuable information to the diagnosis of concussion beyond that of self-reported symptoms alone.
Participation in sports is an important part of New Zealand culture.
In New Zealand, adolescents make up the majority of the sport playing population, with 92 per cent of youth involved in club, school, and recreational sports and physical activity, according to figures from the sports body Sparc.
Whilst there are many benefits that arise from sports participation, there is also risk of injury.
The most common sporting injuries include sprains and strains (46.7%), followed by haematomas (23.9%), lacerations (8.8%), fractures (5.7%), concussions (also known as mild traumatic brain injury; 4.5%), and dislocations (3.7%).
Concussion differs from other sporting injuries in that its symptoms are often subtle and ambiguous, making it difficult to identify.
A survey of New Zealand Rugby League (NZRL) coaches and officials revealed that although all had heard the term “concussion”, only 75% believed they could recognise a concussion if it occurred. However, 39% wrongly believed loss of consciousness was necessary for a concussion to occur, suggesting their ability to identify a concussion is not as accurate as they expected.
Furthermore, nearly half of those surveyed believed all concussions resolved after the same time period, which 78% identified as seven days. Most concerning was that only 8% could identify the NZRL-mandated three-week stand-down period following a concussion, and rugby players themselves reported they felt this was too long.
Not only is their lack of knowledge on concussion disturbing, but of greater concern is their relaxed attitude toward concussion.
For instance, 55% of NZRL coaches and officials surveyed did not seek medical clearance before a concussed player returned to play, according to 2010 research.
Additionally, a survey of New Zealand high school rugby players revealed that only 22% of players who suspected they had sustained a concussion sought medical advice before returning to play, according to 2006 research.
Despite the lack of knowledge at the ground level, sporting organisations are slowly recognising the importance of having concussion assessment methods and policies in place.
This is largely attributable to the increasing amounts of research outlining the serious nature of concussion and the possible long-term consequences.
The United States has taken the lead in concussion management with many of its states implementing sport concussion policies and legislation at professional and amateur levels across several sports.
New Zealand, however, is somewhat behind in its attempts to safely manage sport concussion, utilising only generic policies for all ages in only a few sporting codes and no strategies to ensure they are adhered to.
For instance, Rugby Union is New Zealand’s national sport and has one of the highest concussion risk sports worldwide, yet the country lacks specific, sophisticated policies or guidelines to adhere to when a youth sustains a concussion.
Most high school teams adopt a general stand-down period of three weeks following a concussion in addition to the players self-report of no symptoms.
This is inconsistent with the international Concussion in Sport group’s recommendation of individualised assessment and return-to-play protocol.
Thus, there is a need for more individual, specific forms of concussion assessment in New Zealand sports, Martin and van Ommen suggest.
Those interested can contact van Ommen on firstname.lastname@example.org or call 414 0800 ext 41241 to be part of the research.