New technologies, such as impact-measuring devices and eye-scanning tools, which detect and monitor concussion in athletes may help prevent long-term brain injury, as well as determine when athletes are well enough continue playing.
In contact sports like rugby and Australian Rules Football, it isn’t uncommon to break a leg, twist an arm, or experience a head concussion. While sports-related concussions aren’t anything surprising, the fact that many of these cases go undiagnosed is a concern.
In Australia, the number of sports-related concussions is growing steadily. Between 2002 and 2011, the number of hospitalisations due to sports related “concussions” grew by 60.5 per cent.
Researchers also suspect that there are links between multiple concussions and brain diseases such as Chronic Traumatic Encephalopathy (CTE), as well as Acute Cerebral Oedema. Acute Cerebral Oedema happens when an athlete sustains a second concussion before their brain has fully recovered, resulting in the rapid swelling of the brain.
Traditional Diagnostic Methods for Sports Concussion
The problem lies in diagnosis.
When an athlete suffers a head impact, a concussion is indicated by symptoms such as dizziness, headache, lack of balance and coordination. Many of these symptoms however, are subtle and can often be brushed aside as fatigue or mild exhaustion.
There is also no single test to identify concussion, and of the various neurocognitive tests available, many tend to be subjective. Most medical practitioners turn to the Sport Concussion Assessment Tool (SCAT3), an internationally recommended assessment tool, but even this isn’t sufficient for some experts.
Dr Adrian Cohen, founder of HeadSafe, an education programme, which focuses on the prevention of head injuries, explained that these tests often require an athlete to answer a number of questions that are open to interpretation.
“In the SCAT3 test, players have to rank from 0 to 6 on 22 symptom-related questions such as ‘Do you have a headache?’, ‘Are you dizzy?’ and even ‘How emotional do you feel?’ These tests are too subjective, and can be open to interpretation by athletes and doctors,” he said.
These tests are usually inconvenient to carry out, especially in the middle of an intense match. Players often want to carry on playing, regardless whether or not they are concussed.
“These tests have been called ‘sandbagging tests’, since players experience tremendous pressure from coaches, peers and families, and will often fudge the test results to return to play while they still have concussion,” Dr Cohen added.
A More Objective Way for Diagnosis
Rachael Leafe, a 41-year-old Rugby League player, attaches the X2 X-Patch behind her ear while playing in New Zealand. An accelerometer in the sensor measures the force of impact to her head in G-force, while a gyroscope evaluates the direction of impact (the rotational force).
The downloaded data forms part of her coaches’ post-game analysis, providing valuable information about players most at risk of sustaining a concussion.
“Any unusually high impacts are picked up and discussed with the players,” said Leafe. “It gives us the assurance and confidence to know that this technology was helping monitor and determine impact from contact during a game.”
Dr Cohen, who also used the device to study head impacts among professional rugby union players in Australia, said that the number of diagnosed concussions is fewer than one in ten.
“When we used these sensors, not only were we able to pick up concussions in players that were obvious candidates for concussions, we were able to pick them up in players whose concussions would have gone unnoticed,” said Dr Cohen.
When It’s Safe to Be Back in the Game
Apart from sensors, others are using eye-tracking technology.
Experts have applied eye-tracking technology to the King-Devick Test, an effective tool used to diagnose concussions in athletes quickly on the sidelines.
A simple visual cognitive test is given, which requires players to read numbers across a screen. “It has been extensively and independently verified as a good test to determine if a player is well enough to return to play,” Dr Cohen said.
While this visual test is being conducted, eye-tracking technology reads the athlete’s eye movement to determine how serious the injury is.
“The eye-tracking system provides us with more objective data points that can be used by clinicians to monitor a patient’s post-injury, and make the tough decision about returning players to play or resting them for more recovery,” said Patrick Burkhart, vice president, Clinical Division, King-Devick Test.
With cutting-edge technologies like these, athletes might finally have a better chance of having concussion detected and treated earlier for better long-term health.
Top image: Sports concussion can be difficult to detect and diagnose.