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By IRB Media Unit
• IRB and Unions committed to achieving concussion management best practice
• Initial trials return positive feedback from Unions
• Longitudinal concussion study launched in partnership with NZRU
Underscoring its commitment to enhancing player welfare practices, the International Rugby Board Executive Committee has given dispensation for Unions to trial the pitch-side concussion assessment (PSCA) protocol within their elite domestic competitions.
The move to widen the trial follows positive feedback from Union medical officials and extensive evaluation after successful initial trials of the protocol in this year's IRB age grade events which standardise the procedure of player assessment in line with global medical best practice to enhance player welfare and protection.
Unions will now be able to implement the trial in elite competitions under their jurisdiction where an experienced doctor is in attendance and the ability to review the team doctor’s PSCA decisions is available. Under the trial players who have sustained a head injury with suspicious symptoms or signs will be able to leave the field of play for a standardised assessment undertaken over a five-minute period.
Under the PSCA protocols:
• The recommendation to remove the player can be made by either the referee, the independent match day doctor or the team doctor from the player's team.
• Once that command is made, the referee will indicate that the player is leaving the field of play with a hand signal where he touches his head three times.
• Once the player has been removed from the field of play and temporarily replaced, the team and independent match doctors will proceed through an IRB pitch-side concussion assessment procedure incorporating standardised questions and observations.
• If the player fails any aspect of the assessment and has relevant symptoms he will not be able to return to the field of play and the substitution becomes permanent.
IRB Chief Medical Officer Martin Raftery said: "The safety and welfare of our players is of paramount importance for the IRB and its 118 Member Unions. As a sport, we have been driving forward concussion management development and best-practice policy over the past decade, but we can always do more to protect our athletes.”
"The trials conducted at the IRB Junior World Championship and IRB Junior World Rugby Trophy were greeted extremely positively by participating Unions. For the first time we are able to deliver a standardised procedure of assessment that replaces an on-field ‘on the run’ assessment and is based on medical best practice. It provides an extra layer of protection for our athletes and delivers the ability for the match doctor and the team doctor to make an assessment in a controlled environment."
"It is important to remember that these trials will only operate at the elite level of the Game where there are experienced doctors present. At community level the message is very clear – if there is any doubt then the player should be removed immediately from the game and not return to play."
Furthering its commitment to advancing knowledge, education and best practice in this critical area, the IRB, working in partnership with the New Zealand Rugby Union (NZRU) and Auckland University of Technology (AUT), has commissioned an unprecedented study to examine the potential impact of head injuries and long term health outcomes following exposure to professional Rugby.
The study will feature 200 ex-elite level Rugby players who will be compared against 200 ex-community players and 200 controlled ex-elite sportspeople to examine whether there is a correlation between exposure to Rugby and other activity sports and long-term health issues. All people studied will be in their 40s and 50s and the study will examine overall exposure to Rugby and other activity sports alongside everyday socio-economic and lifestyle factors.
Raftery said: "Presently there is a debate within sport about the long-term effects of concussion. There have been comparisons made in the media between Rugby and American Football, but the nature of the sports, laws and collisions is very different. As an example, hits to the head were only made illegal in American Football in 2010 while in Rugby they have never been allowed under Law."
"The evidence supporting the theory that collision sports have a negative effect on cognitive function has been questioned by many scientists, however it is prudent to undertake these studies in order to broaden our understanding of concussion and ensure that we deliver the best-possible player welfare framework for our athletes."
NZRU General Manager of Professional Rugby Neil Sorensen said the safety of rugby players at all levels of the Game was critical.
“The IRB’s decision to enlist the NZRU and AUT to lead an unprecedented study into the possible long-term effects of exposure to head knocks in Rugby underlines our expertise in this critical area of player safety," he said.
DR MARTIN RAFTERY EXPLAINS THE PSCA ON VIDEO>>
In line with Zurich: The PSCA protocols have been developed by a specialist working group comprising independent experts, Union medics and player body representatives. IRB policies in concussion are in line with concussion evaluation guidelines for suspected concussion as outlined within the Zurich Consensus Statement, of which the IRB is a signatory. Within the PSCA, the IRB has altered a protocol to allow for off-field assessment and an assessment tool incorporates Maddocks questions, balance tests and symptoms review as recommended by Zurich.
The IRB has been at the forefront of driving forward sport concussion research, policies and guidelines in recent years. In 2011 the IRB introduced revised protocols governing concussion evaluation and Graduated Return to Play guidelines, driven by the Concussion Working Group which includes Union medics, independent experts and player body representation. It also launched a fully interactive concussion management education website for players, coaches and doctors, www.irbplayerwelfare.com