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Brain injury

Ice hockey study shows head impacts lead to changes in the brain

The latest results from a multi-year study looking at cognitive function in ice hockey players has revealed that repeated head impacts lead to changes in the brain.



Cognitive function
Concussion and head impact in sport has been in the news a lot recently, with multiple bodies calling for greater protection for players

The research comes from Simon Fraser University and also showed that certain processing responses in players at the start of the season differed when observed in the postseason.

As well as this, the players in the older age group observed more of these changes.

Those involved in the study monitored ice hockey players in Rochester, Minnesota from two different age groups: those 14 and under and those 16 to 20.

They measured the player’s cognitive function using electroencephalography to determine their ‘brain vital signs,’ which includes a person’s auditory sensation, basic attention and cognitive processing.

Head impact in ice hockey usually comes from player-to-player or player-to-board contact, with the researchers wanting to determine if this impact had any effect on brain function.

The majority of these collisions go unnoticed as they are classed as subconcussive, where a person will not show any symptoms afterwards.

However the multi-part study has shown that players’ auditory sensation and cognitive processing were both impacted from playing ice hockey, with these changes in direct correlation with how many head impacts a player has suffered.

Dr Shaun Fickling, lead author of the study, said: “Our research has shown that repetitive subconcussive impacts triggered compounding effects in brain function changes, which underscores the importance of shifting our thinking and understanding of concussions as a singular acute-injury model to a spectrum of head-impact exposure and effects over time.”

In 2019 results from the first part of the study were published which looked at players suffering concussion, which also showed that brain vitals signs were damaged from this.

Furthermore it highlighted that concussion leaves undetected impairments, even after players were cleared to carry on playing under ice hockey’s current protocol.

This is not the only sport where the rules around head impact have come under scrutiny. NR Times recently covered fresh calls from charities and ex-players to change the ‘fundamentally flawed’ guidelines in football.

A recently formed group also did the same for rugby. Those at Progressive Rugby labelled concussion as “the greatest threat to the worldwide game” and called for changes to be made to protect players from developing neurological problems later in life.

“Concussion in sports is a major concern for many,” said Dr. Aynsley Smith, principal investigator of the study. “Our research has shown that having an objective physiological measure of brain function at rink-side is key to detection and managing concussive impacts.”

These head traumas can have huge repercussions for athletes, as NR Times recently found out when speaking to former skeleton athlete Eleanor Furneaux. She was forced to retire from the sport aged only 24 after a major accident while training.

Speaking about the results of the study, professor at Simon Fraser Dr. Ryan D’Arcy, said: “In medicine: you can’t treat what you can’t measure.

“With breakthroughs on measurement challenges, we hope to now accelerate treatment innovations for prevention, acute care and extended care concussion management – for all people across a range of different applications.”

The study is part-funded by USA Hockey, with the results being published in the peer-reviewed journal Brain Communications.

Brain injury

New cycle helmet test discovers true level of protection for cyclists



The effectiveness of bike helmets in protecting against brain injuries caused by collisions at speed has been tested for the first time. 

New helmet technologies have emerged in recent years to mitigate the instances and severity of traumatic brain injury (TBI) in collisions from cycling, but the way this is traditionally tested leaves room for doubt in their findings. 

The majority of real-world cycling-based TBIs are caused by rotational forces on the brain, which are generated by the head hitting the ground at an oblique angle, mostly seen when cyclists fall or collide while moving. 

However, current methods test whether heads are protected from falls at right-angles, which happen mostly when bikes are stationary, and do not account for the rotational forces at play when cyclists fall to the ground at speed.

Now, a new Imperial College London paper has demonstrated a new simulation-enabled helmet testing technique that tests how well helmets protect heads from rotational forces.

Testing 27 different helmets in a purpose-built rig at Research Institutes of Sweden, the project found that newer technologies reduced whole-brain strain compared with older helmets. 

However, they also found that the effectiveness of newer helmets depended on their technology and location of impact – some helmets which were designed specifically to reduce rotational forces didn’t appear to accomplish their aims.

Its findings could be significant in ensuring future safety innovations in cycling helmets, the research team said. 

“The amount of people cycling since the COVID-19 pandemic began has doubled on weekdays and trebled on weekends in parts of the UK,” says lead author Fady Abayazid, of Imperial’s Dyson School of Design Engineering.

“To keep themselves safe, it’s important cyclists know the best way to protect their heads should they have a fall or collision.

“Cyclists falling from motion will most often hit the ground at a non-right-angle. These angles produce rotational forces that subject the brain to twisting and shearing forces – factors contributing to severe TBIs, which can be life-altering. 

“However, current testing standards for bike helmets don’t account for this issue, so we designed a new analysis method to address this gap by combining experimental oblique impacts with a highly detailed computational model of the human brain.”

Senior author Dr Mazdak Ghajari, also of Imperial’s Dyson School of Design Engineering, adds: “With cycling’s popularity soaring, we are seeing more requests from the public and cycling communities for a thorough review of new helmet technologies to inform their purchases. 

“However, this is hard to do without testing that accounts for rotational forces.

“Our research could help to address this gap, inform customers, improve safety, and reduce the frequency and severity of TBIs from cycling.”

The authors are now looking into testing standards for motorbike and industrial helmets and the Dyson School of Design Engineering has also just built its own rig to carry out future experimental helmet impact tests.

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Brain injury

Calvert Reconnections strengthens senior team ahead of opening



A groundbreaking neurorehabilitation centre is helping to plan for its future even before its opening through strengthening its management team. 

Calvert Reconnections is set to open on June 21 and is set to deliver new possibilities in brain injury rehabilitation through its UK-first residential programme which combines traditional clinical therapies with physical outdoor activities. 

The centre, based on the outskirts of Keswick in the Lake District, is now making new additions to its senior team as is prepares for its long-awaited opening, which has previously been delayed due to COVID-19. 

Claire Appleton has become head of service at Calvert Reconnections with Lorna Mulholland appointed as registered manager. 

Claire, an occupational therapist, has 23 years’ experience working in the NHS and has held various community roles including in acquired brain injury, long-term neurological conditions, neurological splinting and stroke rehab.  

Five years ago, Claire moved into a management post in the NHS leading the Eden Community Rehab Team, developing strategic specialist leadership and management skills, and gaining valuable experience delivering high quality health services.

Lorna has 12 years’ specialist experience within the social care sector, principally in acquired brain injury, learning disabilities, mental health and autism. 

She has an extensive knowledge base in delivering care within a residential and supported living setting with experience in complex challenging behaviour.

Sean Day, centre director at Calvert Reconnections, says: “As part of our senior management team, Claire and Lorna have a key role to play in the delivery of our service.  

“Everyone at Calvert Reconnections take great pride in what we do and the difference we can make to people’s lives.”

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Brain injury

UFC adopts concussion protocols for MMA fighters



An official concussion protocol has been created for mixed martial arts (MMA) fighters competing in the UFC, in a first for the sport which builds further on global efforts to safeguard sportspeople from the effects of head injury. 

The UFC Performance Institute has published its protocol, aimed at both fighters and coaches, as part of a 484-page study based on data collected between 2017 and 2019.  

Hailed as the most comprehensive MMA study ever undertaken, it details the UFC’s five-step rules around returning to the sport following concussion or TBI. 

“The goal is we really want to support the ongoing development and performance behaviours and activities in the MMA gyms in the combat community globally,” says Duncan French, the UFC’s vice president of performance. 

“We are slowly aggregating our own insights and our information here in the Performance Institute, and we want to share that. We don’t want the PI to become an ivory tower where the information is only retained for a discrete 600 roster of fighters.”

Further investigation into any different needs for female fighters will be undertaken, the vice president adds. 

“Now, we need to do more work to understand how we can potentially support the ladies if they do have a concussion,” says Duncan. 

“Because that method, that approach to return to play following a concussion in females, might need to be different.”

In the new protocol, the details its return-to-sport approach as being similar to that of the NFL, beginning with up to two days of rest, followed by two stages of no-contact workouts. 

The UFC wants fighters to use its concussion assessment tool, the SCAT5, to monitor progress, and as they improve, fighters can go from no-contact workouts to moderate contact, although still with minimal risk of head contact. 

The final stage includes a return to sparring, and the UFC PI recommends starting with one session each week with no more than three rounds of five minutes, gradually adding more over a period of four weeks until they reach two full sparring sessions of five rounds per session. 

Returning to full contact will need medical clearance, the protocol states.

“For brain injuries like concussion, even if you are feeling symptom-free, a fighter should go through all stages of a return-to-sport protocol to ensure a full brain recovery,” the report says. 

“Further, resuming activity too quickly, especially in contact sports like MMA, not only increases the risk of subsequent musculoskeletal injuries and longer recovery times but also further concussions (e.g. second-impact syndrome) which can lead to chronic neurological conditions, permanent disability and death.”

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