NZ player in pioneering concussion research
Aims include clarity of diagnosis and when it’s safe to play again
In a New Zealand first, a former rugby player with a history of concussions has undergone testing that researchers hope will help provide definitive diagnoses of concussion and a more detailed understanding of its long-term effects on the brain.
On Wednesday, at the AUT Sports Performance Research Institute, Will Gardner underwent a series of tests under the guidance of Canadian exercise physiologist Professor J. Patrick Neary.
Gardner is the first retired New Zealand rugby player to undergo Neary’s protocol to help determine the way in which blood flow to the brain responds to stress.
Gardner was hooked up to equipment that measured his heart rate, breathing and blood pressure. A detector unit was attached to his forehead to measure brain oxygen levels.
The 40-year-old Aucklander has suffered 10 head injuries in 30 years, from mild concussions to being knocked out cold. He suffers symptoms including dizziness and vertigo and is documenting in a blog what he hopes will be a more complete recovery.
The purpose of collecting the data from participants such as Gardner is to provide an objective diagnosis of concussion and, just as importantly, lead to a definitive understanding of when it is safe to return to sport.
Neary’s work is an extension of the ground-breaking research carried out in the New Zealand Rugby Health project, led by the AUT’s Professor Patria Hume. The findings of increased osteoarthritis and decreased brain function in retired rugby players came as no surprise to Hume given the contact nature of the sport but the finding of increased cardiovascular health issues was unexpected.
The findings of the NZ Rugby Health Project were published in online journal Sports Medicine in 2016. Due to public and scientific demand, the project went global, with studies under way in the United Kingdom, Australia, Canada, US, and New Zealand under the leadership of New Zealanders Hume and Dr Doug King, and Dr Karen Hind in the UK.
Neary’s work, Hume says, will add a significant piece to the concussion jigsaw puzzle.
Neary was drawn to the world of head injuries from ice hockey. One of his graduate students was looking at head injuries in hockey players and wanted equipment to measure recovery. Neary had the infrared imaging that shone an optical light into the head to measure blood oxygen levels.
“On one wavelength it gives you an indication as to how much oxygen is bound to haemoglobin. At another wavelength it will show you how much haemoglobin is all by itself without oxygen. Every time you’re
thinking, neurons are firing and have to use oxygen and that requires increased blood supply to the brain.”
Neary realised his picture was incomplete and he needed to measure that blood flow using an ultrasound tool called a Transcranial Doppler.
“We started looking at the physiology of the brain [post-concussion] but our research showed the heart was also affected,” Neary said.
Much of the research around concussion has concentrated almost exclusively on brain function but Neary believes the heart — or blood flow — plays a pivotal role, particularly in rehabbing concussion.
His research shows concussion changes the timing of the heart and heart-rate variability is reduced.
For years, popular theory has been that complete rest accelerates concussion recovery. Neary’s discovery of the connection between the cardio system and concussion, however, leads him to believe recovery should work hand-in-hand with jumpstarting the heart. In this respect he has become an advocate for exercise during recovery, essentially to increase blood flow.
Neary talks about concussion upsetting the autonomic system, which takes care of your internal workings, such as breathing, without you needing to think about it.
“Once we ascertain the level of disruption, we can start to work on what we can use to rehabilitate that faster.”
While there are many aspects to concussion that remain a mystery, understanding when it is safe for players to return is a priority.
It might be too late for Gardner, long since retired, but the data collected from him could be vital for the next generation of players.
Neary is in New Zealand for three weeks and will deliver a public lecture on Thursday, March 15, 6pm at the AUT Millennium, “Do you have a woodpecker brain? The perils of concussion”.