An investigation into mild traumatic brain injury identification, management, and mitigation

Concussion is classified as a mild traumatic brain injury which can be induced by biomechanical forces such as a physical impact to the head or body, which results in a transient neurological disturbance without obvious structural brain damage. Immediate access to tools that can identify, diagnosis and manage concussion are wide ranging and can lack consistency in application. It is well documented that there are frequent incidences of concussion across amateur and professional sport such as popular contact sports like rugby union. A primary aim of this thesis was to establish the current modalities of ‘pitch side’ concussion management, identification, and diagnosis across amateur and professional sporting populations. Furthermore, the research sought to understand existing concussion management and concussion experiences by means of recording the player’s experiences and perceptions (retired professional rugby union players). These qualitative studies sought to gain insights into concussion experiences, the language used to discuss concussion and the duty of care which medical staff, coaching personnel, and club owners have towards professional rugby players in their employment. In addition, possible interventions to reduce the incidence of concussion in amateur and professional sports were investigated. These included a ‘proof of concept’ using inertial measurement units and a smartphone application, a tackle technique coaching app for amateur sports. Other research data investigating the use of neurological function data and neuromuscular fatigue in current professional rugby players as a novel means of monitoring injury risk were included in this research theme. The findings of these studies suggest that there is an established head injury assessment process for professional sports. However, in amateur sport settings, this is not the existing practice and may expose amateur players to an increased risk of post-concussion syndrome or early retirement. Many past professional rugby union players stated that they did not know the effects of cumulative repetitive head impacts. They discussed how they minimised and ignored repeated concussions due to peer pressure or pressure from coaches or their own internal pressures of maintaining a livelihood. These data suggest that players believed that strong willed medical staff, immutable to pressures from coaching staff or even athletes themselves, were essential for player welfare and that club owners have a long-term duty of care to retired professional rugby union players. However, there are anecdotal methods suggested to reduce concussion incidence. For example, neck strengthening techniques to mitigate against collision impacts. There is, no longitudinal evidence to suggest that neck strength can reduce the impacts of concussion in adult populations . Additionally, other factors such as lowering the tackle height in the professional and amateur game is currently being investigated as a mitigating factor to reduce head injury risk. The final theme of the thesis investigated possible methods to reduce injury incidence in amateur and professional athletes. The novel tackle technique platform could assist inexperienced amateur coaches on how to coach effective tackle technique to youth players. The findings from the neurological function data suggests that this may be an alternative way for coaches to assess and gather fatigue data on professional rugby union players alongside additional subjective measures and neuromuscular function data. Recently, the awareness of concussion as an injury and the recognition of concussion in many sports settings has improved. These incremental improvements have led to increased discussion regarding possible measures to mitigate the effects of concussion. There are many additional procedures to be implemented before a comprehensive concussion management is universally available, particularly in amateur and community sports. These necessary processes could be technological advances (e.g., using smart phone technology) for parents and amateur coaches to assist in the early identification of concussion or evidence-based concussion reduction strategies.

Grantor dc:publisher

Oxford Brookes University

Year dc:date

2023

Author dc:creator

• Daly, Edward

Contributors dc:contributor

• Esser, Patrick
• Ryan, Lisa
• Pearce, Alan J

Statement dc:rights

• All rights reserved

Language dc:language

en

DOI dc:identifier

https://doi.org/10.24384/zyy7-6m79

OAI identifier oai:identifier

tle:4e165e07-0b14-47a2-887f-9de709982443:d6bd9758-527a-46cd-bfe2-c433766e8fca:1