Professional rugby players experienced a decline in blood flow to the brain and cognitive function after just one season, new research has found.
The University of South Wales followed a professional rugby team over the course of a year and conducted tests before the season, during the season and at the end of the season.
One crucial finding in the evidence, which will be published on Wednesday afternoon, was the suggestion that repetitive contacts, or sub concussions, rather than just obvious concussive impacts impacted on the ability to reason, remember and formulate ideas.
It follows research last month which found that half of elite rugby players are showing an unexpected reduction in brain volume, and almost a quarter have abnormalities in their brain structure.
That study, which was led by Imperial College and funded by the Drake Foundation, compared the rugby players to people who had not played contact sport and found that a “significant proportion” of the rugby players, of which almost half were assessed shortly after a mild brain injury, were displaying abnormalities.
The new University of South Wales study, which is funded by the Royal Society Wolfson Research Fellowship, only found six concussion incidents among all the players that took part over the course of the year. Every player involved in the study, however, experienced a decline in blood flow to the brain and cognitive function between the beginning and end of the season. “Even over a short period we’re seeing from the rugby players a greater rate of decline in brain function,” Professor Damian Bailey, one of the study’s authors, told the BBC.
“Because the forwards are involved in more contact, as one would expect, we’re seeing a greater degree of impairment relative to the backs. The bigger question and what’s really motivating this research is to then look into the future, to have a snapshot of what are the long-term consequences of this reoccurring contact. We have every reason to believe that the damaging effects could be cumulative over time.”
The study’s authors did also acknowledge limitations in the research, notably that the cognitive tests had found a one point reduction which did not meet the usual three-point “reliable change index” threshold. However, this change index is often considered in isolation, and the study looked at 21 players and also found a decline in blood-bourne, cerebral blood flow regulation as well as cognitive markers across the season.
World Rugby welcomed the new research and said that it had doubled their investment in player welfare and new concussion research and initiatives. In a statement, World Rugby said that they have identified six key action areas and undertaken an evaluation of contact training volume. A study of playing and training head impacts in men’s and women’s community rugby is also imminent. “Both will inform the further introduction of guidelines and preventative measures that best support the welfare of all players,” said a spokesperson.
Kyran Bracken, the former England scrum half, has called on World Rugby to increase its return to play protocol following a concussion. “The game has become more intensive, and more collisions, and yet return to play has gone from three weeks to six stage (with 24 hours for each stage),” he told The Telegraph.
“The return to play protocol is not fit for purpose. We have players struggling and we have seen what has happened in the NFL. Isn’t that enough evidence to say there is a problem? Why don’t we make change until there is absolutely no doubt you can be hurt and have no long term issues if you come back in six days.”
There are concerns that an extension of the return to play protocol to three weeks could have the unintended consequence of encouraging players not to disclose concussion symptoms for fear of missing matches and thus drive reporting of brain injuries “underground”.
Bracken said that the independent medical assessment which has been introduced this year by World Rugby was a “good start” but that “in the meantime players up and down the country will be knocked out and play the following week because they can pass a SCAT test which is absolutely scandalous”.
A group of around 200 former players have begun legal action and allege that the game’s authorities failed to protect them from the risk caused by concussions and head impacts.
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