Evidence of Concussion Signs in National Rugby League Match Play: a Video Review and Validation Study

被引：45

作者：

Gardner A.J. ^{[1
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Howell D.R. ^{[3
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,5
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Levi C.R. ^{[1
,2
]}

Iverson G.L. ^{[6
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]}

机构：

[1] Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Callaghan

[2] Hunter New England Local Health District Sports Concussion Program, John Hunter Hospital, Newcastle, NSW

[3] The Micheli Center for Sports Injury Prevention, Waltham, MA

[4] Division of Sports Medicine, Department of Orthopaedics, Boston Children’s Hospital, Boston

[5] Brain Injury Center, Boston Children’s Hospital, Boston, MA

[6] Center for Health and Rehabilitation, Department of Physical Medicine and Rehabilitation, Harvard Medical School, 79/96 Thirteenth Street, Charlestown Navy Yard, Charlestown, MA

[7] Spaulding Rehabilitation Hospital, Charlestown

[8] MassGeneral Hospital for Children™ Sport Concussion Program, and Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA

[9] Priority Research Centre for Stroke and Brain Injury, Level 5, McAuley Building, Calvary Mater Hospital, Waratah, 2298, NSW

来源：

Sports Medicine - Open | 2017年 / 3卷 / 1期

关键词：

Concussion; Injury management; Return to play; Video analysis;

D O I：

10.1186/s40798-017-0097-9

中图分类号：

学科分类号：

摘要：

Background: Many professional sports have introduced sideline video review to help recognise concussions. The reliability and validity of identifying clinical and observable signs of concussion using video analysis has not been extensively explored. This study examined the reliability and validity of clinical signs of concussion using video analysis in the National Rugby League (NRL). Methods: All 201 professional NRL matches from the 2014 season were reviewed to document six signs of possible concussion (unresponsiveness, slow to get up, clutching/shaking head, gait ataxia, vacant stare, and seizure). Results: A total of 127,062 tackles were reviewed. Getting up slowly was the most common observable sign (2240 times in the season, 1.8% of all tackles) but only 223 times where it appeared to be a possible concussion (0.2% of all tackles and 10.0% of the times it occurred). Additionally, clutching/shaking the head occurred 361 times (on 212 occasions this sign appeared to be due to a possible concussion), gait ataxia was observed 102 times, a vacant stare was noted 98 times, unresponsiveness 52 times, and a possible seizure 4 times. On 383 occasions, one or more of the observable signs were identified and deemed associated with a possible concussion. There were 175 incidences in which a player appeared to demonstrate two or more concussion signs, and 54 incidences where a player appeared to demonstrate three or more concussion signs. A total of 60 diagnosed concussions occurred, and the concussion interchange rule was activated 167 times. Intra-rater reliability (κ = 0.65–1.00) was moderate to perfect for all six video signs; however, the inter-rater reliability was not as strong (κ = 0.22–0.76). Most of the signs had relatively low sensitivity (0.18–0.75), but high specificity (0.85–1.00). Conclusions: Using video replay, observable signs of concussion appear to be sensitive to concussion diagnoses when reviewing known injuries among professional rugby league players. When reviewing an entire season, however, certain signs occur very commonly and did not identify concussion. Thus, the implementation of video review in the NRL is challenging, but can provide a useful addition to sideline concussion identification and removal from play decisions. © 2017, The Author(s).

引用

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