Concussion test against rugby’s hardest knocks
UAE players back quick saliva test that protects against brain injuries
A new saliva test to detect concussion during rugby matches could help to protect players from brain injuries, experts say.
Players and coaches in the UAE have welcomed the research by the University of Birmingham, and say a better understanding of long-term damage from sports-related head injuries is crucial for the future safety of contact sports.
Biomarkers in the saliva and urine of players can indicate if a brain injury has occurred, and could be tested on a handheld device to warn club staff while the match is in progress.
Former UAE fullback Tim Fletcher runs BounceBack Physiotherapy and provides medical services for Abu Dhabi Saracens.
“In my experience, you don’t always spot a concussion immediately and play can continue,” Mr Fletcher said. “There is still an old school way of thinking that if the player can stand up and tell you their name, they are good to continue playing.
“If this development is successful, it is certainly interesting as the biomarkers in saliva could show consistency. There is not even a chance of cheating the system.”
Protocols now lead medical staff to remove a player from the field if they are suspected of having suffered a concussion.
They are then asked a series of “Maddox” questions to assess their memory and coherence.
It helps coaches to recognise signs of a concussion injury, asking questions that players cannot learn answers to as they are continuously changing.
Questions could be who scored the first try of a match, what’s a certain player’s shirt number or who the team played the previous weekend.
Agitation, confusion, headaches, memory loss and dizziness are signs of concussion.
“It is difficult for coaches and support staff as the background knowledge on head injuries is in the learning stage, especially in the UAE,” Mr Fletcher said.
“It can be difficult, as most guys want to get back on the pitch as quickly as possible. Coaches need to explain the situation very quickly about why they are being withdrawn.”
The study is part of the University of Birmingham’s Repetitive Concussion in Sport project, and will run throughout the 2017 to 2018 season of professional rugby in England.
Researchers led by Prof Tony Belli at the College of Medical and Dental Sciences have developed a test over the past nine years.
It is hoped it could be used at grassroots level, schools and in the professional game if further trials are a success.
A handheld device could also be used by medics and the military to improve diagnosis and treatment in the first critical hour of a brain trauma.
Former UAE national team Sevens player Jonny Macdonald was forced to retire from rugby in 2014 after three concussions in two months.
Born and raised in Abu Dhabi, he represented the Arabian Gulf at the Sevens World Cup in 2009, and Scotland at the Hong Kong Rugby Sevens.
Mr Macdonald estimates that he has suffered up to 20 concussions during his career, and has had at least 50 brain scans.
“If the science holds up and the biomarkers are definitive, this saliva test could help the game enormously and stop repeat injuries, where a lot of the damage occurs,” he said.
“If it’s affordable for schools and amateur clubs, that would be a breakthrough. If a doctor makes an assessment on the sidelines here, a player often says he is OK and returns to the field.
“This would give a definitive answer. The referee could then make the decision and take it out of the hands of the player.”
Changes introduced in England for this season include a mandatory 10-minute minimum break for a player, rather than a side-line assessment by a doctor that could allow them back on after two minutes.
Shoulder-high tackles are also now outlawed in the game globally, and result in an immediate red card to help reduce head collisions and dangerous play.
The England Rugby Football Union says concussion remains the most commonly reported injury in the premiership, accounting for almost half of all injuries sustained by the tackler.
Concussion accounts for 20 per cent of injuries sustained by ball carriers and 47 per cent for tacklers.
“People generally are uneducated about head injuries in sport but at least it is now on the agenda,” Mr Macdonald said. “Repeat concussion can have a long-term effect. People should play rugby, but they need to do so in a safe environment.”