Abstract

BACKGROUND: Proper recognition and management of concussion within sport has become a hot topic as research suggests that the mismanagement of these injuries can lead to extended time out of play, and morbidity after a player retires. Computerised neuropsychological testing (CogSport) was introduced in Rugby League (RL) in 2004 to aid in return to play criteria and to help safeguard player’s welfare. AIMS: To identify the incidence and lifetime risk following a concussion over the years 2006-2012 within the Rugby Football League (RFL) and whether a full recovery from concussion lends to an increased risk of subsequent concussions. METHOD: Participant players were those who held a professional contract with the Rugby Football League UK between 2006-2012 representing 39 professional clubs at first and academy team level. It is mandatory within the professional game to provide an annual baseline test and following any diagnosed concussion, with full symptom resolution, a valid return to play test test. Concussion test data was provided by CogState Australia from tests performed over 7 seasons. RESULTS: Over the 7 year period there were 4762 players within the RFL (age range 16-34 years), suffering 470 concussion (2.65/1000 hours). The odds of sustaining 1 concussion was 7%, whereas the chances of receiving 2 or more was 1%. Incidentally, the probability of having 3 or more concussions was 0.2%. The time between concussions for any individual who suffered two or more concussions was on average 355 days. The average return to play time was 1.46 days following the first return to play test. The mean age of suffering a concussion was 22.6years. The study showed a moderate association between age and concussion risk, with each advancing year giving rise to an 8% increased risk of a concussion. CONCLUSIONS: This report is the first to follow RL players over a prolonged period and as such is the first to demonstrate the risk of subsequent concussions. In RL concussions managed correctly and fully resolved have not been shown to have detrimental effects on future concussions and in general there is a lack of evidence linking appropriately managed concussions in other sports to detrimental future effects. Ethics University of Nottingham

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