Major initiatives on player welfare issues     03 Aug 2012    

- New Zealand experts to lead IRB study into long term health effects

The New Zealand Rugby Union (NZRU) confirmed today it would trial Pitch Side Concussion Assessment (PSCA) Protocols during this season's ITM Cup which kicks off on 23 August.

Under the trial players who have 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.

Furthering rugby's commitment to player welfare, the International Rugby Board (IRB), the NZRU and AUT University also announced the commissioning of a major study to examine long term health outcomes after a career in professional rugby. Players' health outcomes will be compared for professional rugby players, community rugby players and non contact elite sports players. The potential impact of head injuries and long term health outcomes will be one focus of the study.

NZRU General Manager Professional Rugby Neil Sorensen said the safety of rugby players at all levels of the game was critical. "The PSCA trial complements our compulsory coaching and refereeing safety programme, RugbySmart, which focuses on ensuring safe technique across the game.

"As well, the IRB's decision to enlist the NZRU and AUT to lead an unprecedented study into the possible long term health effects is a prudent step, builds on the vast amount of welfare-related activity NZRU has been involved in already and underlines our commitment to ensuring the safest possible environment for our players."

Professor Patria Hume says AUT was delighted to be involved in such an important study. "This is a perfect example of the kind of research we are focussed on. We are analysing high performance athletes with the findings to benefit elite sportspeople and the wider community."

Pitch Side Concussion Assessment Protocols
The New Zealand PSCA trial follows positive feedback from medical officials and extensive evaluation after successful initial trials of the protocol in this year's IRB age grade events.

The standardisation of the procedure of player assessment at the professional level is in line with global medical best practice to enhance player welfare and protection.

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. It's really pleasing to see the protocols incorporated into the ITM Cup and this will give us further evidence on top of the positive feedback we already have."

Sorensen confirmed the trials will only operate at the professional level of the game where there are experienced doctors present. "The professional game has the benefit of trained and experienced medical people on the sideline. At the community level our message to coaches, referees and players is very clear - if there are any signs of concussion then the player should be removed from the play immediately and not return to action."

Study to provide valuable information about neuropsychological and health outcomes of rugby players
The IRB-commissioned study with the NZRU and AUT, which was approved last month, will feature 200 ex-elite level rugby players, 200 ex-community rugby players and 200 non-rugby ex-sportspeople in their 40s and 50s. It will examine whether there is a correlation between exposure to rugby and other activity sports and long-term health issues.

"Presently there is a debate regarding the long-term effects of concussion," said Raftery. "There have been comparisons made in the media between rugby and American Football, but the nature of the sports, the laws and the collisions are very different.

"The evidence supporting 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."

The study will involve the collaboration of IRB Chief Medical Officer Martin Raftery, NZRU Senior Scientist Injury Prevention and High Performance Dr Ken Quarrie with researchers Dr Matthew Brughelli, Dr Doug King, Dr Alice Theadom and Dr Denise Taylor from AUT University led by Professor Patria Hume. Additional collaborators include Professor Stephen Marshall, the Director of the Injury Prevention Research Center at the University of Chapel Hill, and Dr Melissa Purnell and Ms Bronwen McNoe from the Injury Prevention Research Unit, University of Otago.