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Is this mouthguard set to revolutionise player safety?

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Football and rugby are currently at the front of the concussion debate

The announcement that Liverpool and Manchester City are to trial a high-tech mouthguard for a new study into heading is the latest move in football’s efforts to tackle the mounting controversy about player safety. NR Times meets the creators of the revolutionary Protecht mouthguard

With the links between sports like rugby and football and head injuries causing later-life neurological problems becoming increasingly clear, such globally-loved sports are facing some huge challenges.

Played by global icons who are adored by millions, the emphasis is increasingly shifting onto what may await them further down the line, after a career during which they will undoubtedly sustain regular head impacts through heading the ball, colliding with other players or falling to the ground.

Currently, a number of celebrated rugby players are involved in a landmark legal action over claims the sport has left them with lasting brain damage. And recently, former Leeds Rhinos captain Stevie Ward retired from the sport aged only 27, due to the lasting effects of concussion, which he said have left him unable to exercise at all without aggravating his symptoms.

Football also came firmly into the picture last year, following a groundbreaking research project by Dr Willie Stewart, consultant neuropathologist at the Queen Elizabeth University Hospital, Glasgow, which revealed that footballers were three-and-a-half times more likely to die of neurodegenerative disease than age-matched members of the general population.

As former England striker Chris Sutton assessed: “Premier League clubs nowadays have members of staff who monitor everything from how many sprints you made in a match to how much sleep you got last night. They measure the lot. Yet what is not measured is potentially the most important thing — what is happening to your head on a day to day basis. I find that remarkable.”

Change clearly needs to happen, both to safeguard those currently playing sports, as well as the future generations. Failure to act could, say experts, impact on the willingness of parents to allow their children to participate, adversely affecting the future of such mainstream sports from grassroots level upwards.

While only a seismic change in how football and rugby are played can prevent any form of head injuries happening – and with trials for concussion substitutes in football underway in the Premier League – the ability to gain greater insight into what is happening to players on the pitch in real time is a crucial intervention.

And that is where a new invention comes in, adding a high-tech twist to old-school sports equipment to result in a creation which could help to revolutionise safety in contact sport.

Following extensive testing and development, and the creation of market-leading software, Swansea-based startup SWA has devised Protecht, a mouth guard which contains the technology to convey information to pitch side computers in real time, telling them instantly the level of impact a player has sustained.

Through being able to measure the force and impact of every head impact – collecting 102 milliseconds of information around the head trauma, of which three milliseconds will be the actual impact – a club’s medical team can be fully informed and make evidence-based decisions over whether someone needs to be examined, replaced or protected.

Rugby has been keen to act, with Protecht in use by a host of Premiership clubs. Boxers and MMA fighters have also begun to use the high-tech mouth guard.

Now, with the announcement about Liverpool and Manchester City taking part in a trial of the mouth guard, perhaps football is set to follow suit.

“This is a brand new area for football, where mouth guards are not commonly used, but we are starting to come onto their radar and we hope that’s where it’s going,” says Chris Turner, chief executive of SWA.

“In rugby, which is where we started, we’ve made great strides there. We hear from the clubs who use Protecht that it’s working very well. We heard from one club who did a two-day training cycle, one light impact and one heavy. Through being able to see the data we collect, they realised they were actually both the same.

“Studies are showing that when players hit each other there is very little impact, the greater impact comes when they hit the floor. That kind of insight is hugely valuable.

“It could be that one player has a series of impacts in the first half of a match, and handles those impacts very well, and their neck strength can cope with that. But into the second half, that neck strength and endurance starts to evaporate, and the impact of these impacts is doubled. We’ve never had the real time data to tell us that before.

“From the sidelines, for the first time it can be seen in great detail what is going on with players, and the impacts they are taking. The information from their mouth guards is passed on in real time and decoded there and then.”

Professor Mike Loosemore, a leading figure in sport and exercise medicine and concussion expert, who has advised SWA on the creation of their mouth guard, believes the adoption of Protecht can be vital in attributing where head injuries come from.

“It can help us understand what needs to be changed, particularly in football. A lot of sports are starting to adopt concussion protocols, but football has not really been at the forefront of the head injury and concussion debate until more recently,” he says.

“Although heading the football means the head impacts with the ball, can we really attribute heading the football to head injuries? We have found in other sports that head injuries have not been caused not by the impact itself, but by the subsequent collision from falling onto the ground.

“Maybe it’s that we just don’t know, and to take a decision like banning heading in football would change the sport hugely. And if you stop heading, which will make players’ necks weaker, this may lead to an increase in head injuries from falling down. This mouth guard will have a huge impact in finding out exactly where the head injury has come from.”

While its positive impact in safeguarding players is already being seen by sports professionals – “It allows us to build a pool of data on how much contact they tend to take in a week, per training session and in a game,” says Harlequins’ head of medical Mike Lancaster – the impact of the absence from sport for any period of time means they need to be afforded even greater protection, says Chris.

“Many players are returning to contact after an absence due to COVID, or perhaps an injury, and that can have a big impact. We can collect an enormous amount of data to show how they are conditioned after an absence, how they are reacting and dealing with impact, and this can be of huge importance when raising the intensity,” says Chris, who previously held executive roles at Unilever and SAP before starting SWA.

“It can be very useful in helping a team manager to manage players. A healthy player is a good player, and returning to sport after COVID does pose risks. Athletes, during a period away can become deconditioned, and are more susceptible to injuries, including head injuries,” agrees Professor Loosemore.

“This mouth guard can alert you to that. The technology behind this is very advanced, and we can see in real time, as it happens, the need to protect athletes, particularly when returning to contact after an absence.”

With adoption at the highest levels of English rugby, clearly clubs see Protecht as a key factor in ensuring the safety of their players. But is this the solution to the problem of the consequences of head injuries in sport?

“Through being able to relay this real time information through these 102 millisecond waves around a head impact, we are helping to increase understanding around where head injuries come from and are putting this information directly into the hands of club doctors and their teams,” says Chris.

“This will help more people to play sports more safely. We want to help protect future generations.

“We have spent a lot of time and money developing the mouth guard, testing it, ensuring it is reliable and accurate, and we are very pleased with its impact and the feedback we are receiving from those who are using it.”

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Flu vaccinations to become compulsory for care staff?

Plans to introduce mandatory flu jabs could be “one step too far” for an already under-pressure sector, leaders warn

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The introduction of compulsory flu vaccinations for care home staff could be “one step too far” for a sector already battling a recruitment crisis amidst the ongoing impact of COVID-19, leading professionals in the industry have told NR Times. 

The Government is currently consulting with key bodies in health and social care over whether to introduce a statutory requirement for vaccination against flu as a condition of employment for frontline workers. 

This follows the move to make COVID-19 double vaccination compulsory, which some forecasters predict could see up to 30 per cent of social care workers leave their roles in a sector already struggling to meet the soaring demand for its services, with an existing and growing shortfall of at least 80,000 staff nationally.

The consultation, which concludes next week, is likely to be met with “fury and outrage” by care operators, many of whom have battled to stay afloat over the past 18 months with mounting staffing and financial challenges. 

SAGE has advised that the combination of flu and COVID-19 could make this winter more of a threat than ever before to the most vulnerable people, particularly those in specialist care environments, and that vaccination is a tool in preventing the transmission of both.

In its consultation paper, titled ‘Making vaccination a condition of deployment in the health and wider social care sector’, the Department of Health and Social care says that flu vaccine uptake among social care workers in care homes was around 33 per cent last year – including 48 per cent for those directly employed and 36 per cent for those employed through an agency – which is significantly lower than uptake of the COVID-19 vaccine.

But for operators already under pressure to meet the needs of their residents while losing staff over the COVID-19 vaccination issue, the worry is that more leaving the profession over the compulsory flu jab may tip the balance. 

One senior figure in a care operator, who wished to remain anonymous, told NR Times: “This is one step too far, particularly so soon after we’ve been forced to lose good people because of the COVID vaccination. 

“Smaller operators are struggling to stay afloat. We’re doing all we can but these are very difficult times. People say we’re through the worst, and in some ways that is true, but the staffing situation is getting worse. By forcing more people out of the sector, the future is very worrying.” 

Paul TM Smith – consultant to Renal Health Ltd and a leading name in specialist care, who is also part of the Royal College of Nursing’s older people’s forum – confirmed to NR Times that the RCN was invited to be part of the consultation. 

“The recent report from MPs (Coronavirus: lessons learned to date) highlighted many failures in the Government’s handling of COVID, but also showed the success of the vaccination programme. There is absolute terror at the prospect of a fourth or fifth wave of COVID, particularly as we come into flu season,” he says. 

“So, given that, I can understand where this approach by the Government comes from – but the situation with the COVID vaccinations has been rushed through and care homes now risk being hit again. And I can’t see it being a one-off for this year, as COVID isn’t going away. 

“I think there will be fury when this becomes known, there will be outrage from many. I worry this could be one vaccination too far and I’d be hesitant to say I’m 100 per cent convinced a policy around compulsory flu vaccinations for staff would be a good thing.

“We’ve seen that clinical advice and political action can be poles apart, and the Government aren’t bound to take that advice. The implications for the sector need to be fully considered.”

While many social care workers will qualify for free flu jabs, not all will, and a lack of clarity also exists over who would have to fund compulsory vaccinations. 

“If it starts costing people to be vaccinated, people who are on low pay working in very challenging conditions, then it becomes a levy. And if this falls to operators, up to 85 per cent of whom are very small operations, this will be a very significant expense for them at a time when they can’t afford any more financial pressures,” says Paul. 

The care home operator adds: “For any care staff in our homes who didn’t qualify for a free flu vaccination, I couldn’t possibly allow them to pay; but then that’s yet another outlay for us. I would hope there may be some Government support there, and that they appreciate how under pressure we really are.”

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Long COVID symptoms ‘typically last up to six months’

Research shows more than half of people with COVID-19 will go on to experience long-term Long COVID symptoms

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More than half of the 236million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience Long COVID symptoms up to six months after the initial virus, new research has revealed. 

During their illnesses, many patients with COVID-19 experience symptoms such as tiredness, difficulty breathing, chest pain, sore joints and loss of taste or smell.

But its impacts, both mentally and physically, can extend into a range of further debilitating issues which can last for months – which the research team at Penn State College of Medicine saying their study findings should leave governments, healthcare organisations and public health professionals in no doubt over the scale of COVID-19 survivors who will need care for a variety of psychological and physical symptoms.

Until recently, few studies have evaluated patients’ health after recovering from the Coronavirus. To better understand the short- and long-term health effects of the virus, the researchers examined worldwide studies involving unvaccinated patients who recovered from COVID-19.

According to the findings, adults, as well as children, can experience several adverse health issues for six months or longer after recovering from COVID-19.

The researchers conducted a systematic review of 57 reports that included data from 250,351 unvaccinated adults and children who were diagnosed with COVID-19 from December 2019 through to March 2021. 

The researchers analyzed patients’ health post-COVID during three intervals at one month (short-term), two to five months (intermediate-term) and six or more months (long-term).

According to the findings, survivors experienced an array of residual health issues associated with COVID-19. Generally, these complications affected a patient’s general wellbeing, mobility or organ systems. 

Overall, one in two survivors experienced long-term COVID manifestations and the rates remained largely constant from one month through to six or more months after their initial illness.

Issues with general wellbeing, mobility, neurological impacts and mental health disorders all featured heavily in the long-term symptoms. 

“These findings confirm what many health care workers and COVID-19 survivors have been claiming, namely, that adverse health effects from COVID-19 can linger,” said co-lead investigator Vernon Chinchilli, chair of the Department of Public Health Sciences. 

“Although previous studies have examined the prevalence of Long COVID symptoms among patients, this study examined a larger population, including people in high-, middle- and low-income countries, and examined many more symptoms. Therefore, we believe our findings are quite robust given the available data.”

“The burden of poor health in COVID-19 survivors is overwhelming,” said co-lead investigator Dr. Paddy Ssentongo, assistant professor at the Penn State Center for Neural Engineering. 

“Among these are the mental health disorders. One’s battle with COVID doesn’t end with recovery from the acute infection. Vaccination is our best ally to prevent getting sick from COVID-19 and to reduce the chance of Long COVID even in the presence of a breakthrough infection.”

The mechanisms by which COVID-19 causes lingering symptoms in survivors are not fully understood. These symptoms could result from immune-system overdrive triggered by the virus, lingering infection, reinfection or an increased production of autoantibodies. 

According to the researchers, early intervention will be critical for improving the quality of life for many COVID-19 survivors. They said that in the years ahead, healthcare providers will likely see an influx of patients with psychiatric and cognitive problems, such as depression, anxiety or post-traumatic stress disorder, who were otherwise healthy before their COVID-19 infection. 

Based on these findings, healthcare providers should plan and allocate resources accordingly in order to effectively monitor and treat these conditions, the team said. 

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A Chance for Life extends neurorehab in the North

The move will extend the range of patient services in the area and improves patient journeys

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Neurological physiotherapy provider Neurocare Physiotherapy now falls under the umbrella of complex case management and rehabilitation specialist A Chance for Life. 

The move extends the range of patient services in the North and improves patient journeys, too.

There is an inevitable challenge for any organisation delivering neuro rehab. With such a wide range of conditions to treat, it can be difficult for any organisation to build a pool of expertise large and diverse enough to service them all.

But Louise Chance, founder of A Chance for Life Ltd, the specialist in rehabilitation support work, case management, physiotherapy, occupational therapy and medico-legal reporting, has found a solution to that challenge.

Louise has combined her team’s capabilities with those of Lancashire-based Neurocare Physiotherapy. 

For almost two decades, Neurocare Physiotherapy has treated patients across the North West of England for neurological conditions such as stroke, multiple sclerosis (MS), Parkinson’s, foot drop, head injury and other disorders.

For much of that time, A Chance for Life has worked in a similar space from its base in Penrith, providing support for clients who often have a variety of social, physical, mental and vocational needs.

Louise saw an opportunity to bring the two organisations together: “We saw that what we do and where we do it dovetails nicely.

“Being able to expand the range of care we offer across the North of England and Southern Scotland is so important, because it means our clients can access more of the support they need from a single source.”

Get in touch to find out more on 01768 891709.

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