Keywords
head injury
rugby
How to Cite
Abstract
Introduction. Concussions (CC) are a subset of traumatic brain injuries that cause functional impairment in the brain. They occur mainly in contact sports and can also happen repeatedly, with rugby being a sport with a higher probability than others due to the characteristics of the game. The clinical manifestations of CTE can be grouped into four main domains: physical-somatic symptoms, emotional function, cognitive function, and sleep habits. Symptoms may appear hours or days later and still indicate a CB. Objective. To determine the frequency of rugby players who have suffered a CB during sports practice, investigating the care and return-to-play protocols applied in a timely manner. Materials and methods. Quantitative, descriptive, cross-sectional study. It included male federated players from the senior rugby team of Club Gimnasia y Esgrima de Rosario, Santa Fe province (Argentina) who participated in the 2018-2021 season games. Survey via Google Form (structured online questionnaire). Results. Age range: 18-40 years. Fifty-eight per cent of players reported having suffered a concussion during sports practice; 25% stated that, suspecting a concussion, they avoided medical attention so as not to be removed from the game. Most frequent immediate symptoms: headache (45%), dizziness (41%), blurred vision (37%), loss of consciousness (26.5%), balance disorders (24%) and memory disorders (22%). After examinations at the site of the concussion, almost half of the players had to be referred to an emergency centre for neuroimaging diagnosis, and half of them needed to be admitted for observation. One in three players affected by concussion did not complete the minimum recovery stages before returning to training. Conclusion. In our experience, it affected almost 60% of the players surveyed. The most common immediate symptoms were headache (45%), dizziness (41%) and blurred vision (37%), which were the three most frequently reported symptoms.
References
1. Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Johnston K, Kelly J, et al. Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001. Br J Sports Med. 2002;36(1):6-10.
2. Bailey CM, Echemendia RJ, Arnett PA. The impact of motivation on neuropsychological performance in sports-related mild traumatic brain injury. J Int Neuropsychol Soc. 2006;12(4):475-84.
3. Canadian Academy of Sport Medicine Concussion Committee. Guidelines for assessment and management of sport-related concussion. Clin J Sport Med. 2000;10(3):209-11.
4. Casas Pareras I, Campero A, Freue R. Manual de neurología. 4a ed. Buenos Aires: Editorial Journal; 2020.
5. Chalmers DJ. Mouthguards: protection for the mouth in rugby union. Sports Med. 1998;25(5):339-49.
6. Charry JD, Cáceres JF, Salazar AC, López LP, Solano JP. Trauma craneoencefálico: revisión de la literatura. Rev Chil Neurocir. 2017;43(2):177-82.
7. Clínica Mayo. Encefalopatía traumática crónica. Disponible en: https://www.mayoclinic.org
8. Covassin T, Schatz P, Swanik CB. Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery. 2007;61(2):345-51.
9. Decq P, Gault N, Blandeau M, Kerdraon T, Berkal M, ElHelou A, et al. Long-term consequences of recurrent sports concussion. Acta Neurochir. 2016;158(2):289-300.
10. Du Preez EJ, Graham KS, Gan TY, Moses B, Ball C, Kuah DE. Depression, anxiety, and alcohol use in elite rugby league players over a competitive season. Clin J Sport Med. 2017;27(6):530-5.
11. Echemendia RJ, Meeuwisse W, McCrory P, Davis GA, Putukian M, Leddy J, et al. SCAT5: background and rationale. Br J Sports Med. 2017;51(11):848-50.
12. Echemendia RJ, Julian LJ. Mild traumatic brain injury in sports: neuropsychology’s contribution. Neuropsychol Rev. 2001;11(2):69-88.
13. Erlanger D, Kaushik T, Cantu R, Barth JT, Broshek DK, Freeman JR, et al. Symptom-based assessment of concussion severity. J Neurosurg. 2003;98(3):477-84.
14. Ferry B, DeCastro A. Concussion. StatPearls. Treasure Island: StatPearls Publishing; 2021.
15. Frommer LJ, Gurka KK, Cross KM, Ingersoll CD, Comstock RD, Saliba SA. Sex differences in concussion symptoms of high school athletes. J Athl Train. 2011;46(1):76-84.
16. Georges A, Das JM. Traumatic brain injury. StatPearls. Treasure Island: StatPearls Publishing; 2021.
17. Giza CC, Kutcher JS, Ashwal S, Barth J, Getchius TS, Gioia GA, et al. Evidence-based guideline update: concussion in sport. Neurology. 2013;80(24):2250-7.
18. Gouttebarge V, Hopley P, Kerkhoffs G, Verhagen E, Viljoen W, Wylleman P, et al. Mental disorders in professional rugby players: a cohort study. Eur J Sport Sci. 2018;18(7):1004-12.
19. Gouttebarge V, Kerkhoffs G, Lambert M. Mental disorders in retired rugby players. Eur J Sport Sci. 2016;16(5):595-602.
20. Guskiewicz KM, Weaver NL, Padua DA, Garrett WE. Epidemiology of concussion in football players. Am J Sports Med. 2000;28(5):643-50.
21. Hacking C. Cerebral edema. Radiopaedia. 2018. Disponible en: https://radiopaedia.org
22. Hind K, Konerth N, Entwistle I, Hume P, Theadom A, Lewis G, et al. Mental health of retired rugby players. Sports Med. 2021.
23. Hollis SJ, Stevenson MR, McIntosh AS, Shores EA, Collins MW, Taylor CB. Mild traumatic brain injury in rugby players. Am J Sports Med. 2009;37(12):2328-33.
24. Hume PA, Theadom A, Lewis GN, Quarrie KL, Brown SR, Hill R, et al. Cognitive function in former rugby players. Sports Med. 2017;47:1209-20.
25. Iverson GL, Howell DR, Van Patten R, Bloomfield P, Gardner AJ. SCAT5 normative values. Front Sports Act Living. 2021;3:653743.
26. Kilic Ö, Hopley P, Kerkhoffs GM, Lambert M, Verhagen E, Viljoen W, et al. Concussion and mental health in rugby. BMJ Open Sport Exerc Med. 2019;5(1):e000693.
27. Kirkwood G, Parekh N, Ofori-Asenso R, Pollock AM. Concussion in youth rugby: systematic review. Br J Sports Med. 2015;49(8):506-10.
28. Knapik JJ, Marshall SW, Lee RB, Darakjy SS, Jones SB, Mitchener TA, et al. Mouthguards in sport activities. Sports Med. 2007;37(2):117-44.
29. Kontos AP, Elbin RJ, Schatz P, Covassin T, Henry L, Pardini J, et al. Post-concussion symptom scale. Am J Sports Med. 2012;40(10):2375-84.
30. Lau BC, Lovell MR, Collins MW, Pardini J. Predictors of recovery in athletes. Clin J Sport Med. 2009;19(3):216-21.
31. Lovell MR, Iverson GL, Collins MW, Podell K, Johnston KM, Pardini D, et al. Post-concussion scale reliability. Appl Neuropsychol. 2006;13(3):166-74.
32. Makdissi M, Darby D, Maruff P, Ugoni A, Brukner P, McCrory PR. Natural history of concussion. Am J Sports Med. 2010;38(3):464-71.
33. Marshall SW, Spencer RJ. Concussion in rugby. J Athl Train. 2001;36(3):464-71.
34. Martín-Rodríguez F, López-Izquierdo R, Mohedano-Moriano A, Polonio-López B, Maestre Miquel C, Viñuela A, et al. Traumatic brain injury and adverse events. Int J Environ Res Public Health. 2020;17(5):1504.
35. McCrea M, Guskiewicz K, Randolph C, Barr WB, Hammeke TA, Marshall SW, et al. Prolonged recovery after concussion. J Int Neuropsychol Soc. 2013;19(1):22-33.
36. McCrory P, Meeuwisse W, Dvořák J, Aubry M, Bailes J, Broglio S, et al. Consensus statement on concussion in sport. Br J Sports Med. 2017;51(11):838-47.
37. McIntosh AS, McCrory P, Finch CF, Best JP, Chalmers DJ, Wolfe R. Padded headgear in rugby. Med Sci Sports Exerc. 2009;41(2):306-13.
38. McKee AC, Daneshvar DH, Alvarez VE, Stein TD. Neuropathology of sport. Acta Neuropathol. 2014;127(1):29-51.
39. McMillan TM, McSkimming P, Wainman-Lefley J, Maclean LM, Hay J, McConnachie A, et al. Long-term outcomes after repeated concussion. J Neurol Neurosurg Psychiatry. 2017;88(6):505-11.
40. Merritt VC, Rabinowitz AR, Arnett PA. Predictors of symptom severity after concussion. J Clin Exp Neuropsychol. 2015;37(3):265-75.
41. Mtui E, Gruener G, Dockery P. Fitzgerald neuroanatomía clínica y neurociencia. Barcelona: Elsevier; 2016.
42. Ortega Zufiría JM, Prieto NL, Cuba BC, Degenhardt MT, Núñez PP, López Serrano MR, et al. Traumatismo craneoencefálico leve. Surg Neurol Int. 2018;9:16-28.
43. Ortiz MI, Murguia Cánovas G. Concussion associated with head trauma in athletes. Medwave. 2013;13(1).
44. Ortiz-Jiménez X, Akena-Fernández M, Saldaña-Muñoz B, Rincón-Campos Y, Góngora-Rivera F, Arango-Lasprilla JC. Evaluación neuropsicológica de conmoción cerebral. Cuad Psicol Deporte. 2020;20(1):236-51.
45. Ponsford J, Cameron P, Fitzgerald M, Grant M, Mikocka-Walus A, Schönberger M. Predictors of postconcussive symptoms. Neuropsychology. 2012;26(3):304-13.
46. Rincón S, Gupta R, Ptak T. Imaging of head trauma. Handb Clin Neurol. 2016;135:447-77.
47. Rouviere H, Delmas A. Anatomía humana. Tomo I. Barcelona: Masson; 1999.
48. Rouviere H, Delmas A. Anatomía humana. Tomo III. Barcelona: Masson; 1987.
49. Russo MJ, Salvat F, Saco M, Della Vedova F, Alonso Hidalgo I, Blaquier JB, et al. Protocolo para conmociones cerebrales asociadas al deporte. Neurol Argent. 2020;12(2):113-23.
50. Viviers PL, Viljoen JT, Derman W. Rugby injury epidemiology review. Sports Health. 2018;10(3):223-7.
51. World Rugby. Concussion guideline. 2021. Disponible en: https://www.world.rugby
52. World Rugby. Global participation in rugby. 2017. Disponible en: https://resources.world.rugby
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Copyright (c) 2023 Tomás Avila Poletti, Mónica TabordaAutor, Juan Carlos Matassa (Author)