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Brain injury

Limiting screen time after concussion ‘cuts duration of symptoms’

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Limiting screen time for young adults after concussion results in shorter duration of symptoms, new research has revealed. 

A clinical trial of 125 young adults shows that those who limited screen time for 48 hours immediately after suffering a concussion had a significantly shorter duration of symptoms than those who were permitted more screen time. 

These findings offer the first clinical evidence that restricting time spent at a computer, television or phone screen in the acute period following a concussion can reduce the duration of symptoms. The study supports preliminary clinical recommendations to limit screen time.

The US Centers for Disease Control and the International Concussion in Sports Group recommend a period of complete cognitive and physical rest for 24 to 48 hours following a concussion diagnosis. Yet there are no clear guidelines regarding what constitutes cognitive rest during this period.

“It’s one thing parents and children always ask in the emergency department,” said lead author Theodore E. Macnow, assistant professor of paediatrics at UMass Chan Medical School. “Is screen time allowed?

“We’re still learning how to treat concussions and there are no clear recommendations regarding screen time. Nobody has yet looked at this question in a rigorous way. We wanted to get a better handle on this question, so we conducted a randomized clinical trial.”

From June of 2018 to February of 2020, Macnow and colleagues assessed 125 patients aged from 12 to 25 who presented with a concussion to the Emergency Department at UMass Memorial Medical Center, the clinical partner of UMass Chan Medical School in Worcester. 

Patients were assessed and randomly placed in one of two cohorts. The first cohort was instructed to abstain from any electronic screens for 48 hours, while the second group was allowed any form of screen so long as it didn’t induce symptoms. Both groups were advised to avoid work and schoolwork for the first 48 hours.

Patients completed a Post-Concussion Symptom Scale (PCSS) at the time of diagnosis and every day for the 10-day study. The PCSS is a 22-symptom scale, which grades each symptom from 0 (not present) to 6 (severe) and reliably detects change over time in concussed patients. 

In the absence of a head injury, a baseline score of less than three on the PCSS survey is considered normal. Additionally, patients completed a screen time survey on days one to three and an activity survey from days four to 10.

An analysis of the data showed that the group permitted screen time during the initial 48 hours after a concussion experienced a significantly longer time to recover, measured by a PCSS score of less than three. 

On average, this group experienced a median time of eight days until symptom resolution compared to 3.5 days for the group that abstained from screen time. During this time, the cohort permitted screen time logged a median of 630 minutes over the 48-hour period while the cohort abstaining from screen time logged a median of 130 minutes.

“These findings support the conclusion that brief screen time abstinence following a concussion is associated with a faster recovery,” said Macnow. “Given this data, preliminary clinical recommendations should be to limit screen time.

“It’s not clear why screen time exacerbated concussion symptoms but there are a lot of reasons to suspect it’s not good.” 

Further research is needed to establish the true pictures, added Macnow. 

“These findings suggest that a larger, more diverse, multicenter study is warranted to see if the results are consistent,” he said. 

“What’s more, we only looked at the first 48 hours after diagnosis. It would be worthwhile to see if abstaining from screen time longer had more of an impact or if specific screen time activities—video games vs. television—have a more pronounced effect on recovery time.”

Brain injury

PFA leaders pledge to donate brain to Concussion Legacy Project

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Two senior figures at the PFA have pledged to donate their brain to research as part of the pioneering Concussion Legacy Project to protect future generations of players. 

PFA Chief Executive Maheta Molango and PFA Chair John Mousinho have both made the pledge through a partnership with the Concussion Legacy Foundation UK, following the lead of England Rugby World Cup winner Steve Thompson.

The Concussion Legacy Project, unveiled yesterday, will research Chronic Traumatic Encephalopathy (CTE) and other consequences of brain trauma in athletes and military veterans in the UK.

PFA Chief Executive Molango, a former striker at Brighton & Hove Albion, Lincoln City and Oldham Athletic, said: “While being very mindful of taking immediate steps to protect current players, in the long-term ongoing research is vital to enable us to be able to answer more questions and best support members.

“We have been listening and engaging with leading academic experts, and they tell us that brain donation is a key piece to the puzzle in understanding CTE. We are excited to join a global network of the most prominent researchers in this area.”

Yesterday, Steve Thompson became the first athlete to pledge to the Concussion Legacy Project’s Brain Bank, with the former Lion previously stating that he cannot remember playing in England’s 2003 World Cup final win over Australia.

Today, Oxford United’s captain Mousinho, who has amassed over 500 league appearances over a fifteen-year professional career, committed his support for the project.

PFA Chair Mousinho explained: “Brain donation is an intensely personal decision for former players and their families. However, I have been inspired by the team at the Concussion Legacy Foundation and The Jeff Astle Foundation, and I have decided to commit my brain to future research in the hope that it can help play a part in protecting future generations.

“The Concussion Legacy Foundation has a strong ethos of supporting families and everyone affected by brain injury, and they are values we share at the PFA.”

Dawn Astle, who has been campaigning for two decades for football’s authorities to publicly recognise a link between the repeated heading of a football and dementia in later life, has given her full support to the new concussion initiative.

Speaking on behalf of The Jeff Astle Foundation, she said: “Brain donation is the most valuable gift of all for future generations of footballers. It may be many years before this jigsaw is complete but adding each piece, one at a time is the only way we will understand the true picture and make a better future for others.

“The Jeff Astle Foundation encourages families of athletes and veterans to donate the brain of their loved one to the Concussion Legacy Project at PledgeMyBrain.org.”

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Brain injury

‘We want to be part of the solution – for Bill and future generations’

Dr Judith Gates speaks to NR Times about this weekend’s football match organised by Head for Change, which will be the first ever to involve no heading of the ball

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The first football match which involves no heading of the ball will help raise awareness and stimulate conversation about the impact of head injury in sport, its organisers have said. 

The 11-a-side match, involving 25 former professional footballers, has been hailed as an experiment as researchers try to discover whether the game can function without heading, in light of ever-growing research which links football to neurodegenerative disease.

It is organised by Head for Change, the organisation helping to drive forward calls for changes to player safety, and will only allow headers in the penalty box for the first half and then restrict all heading during the second half. 

It will be held at Spennymoor Town Football Club, in County Durham, on Sunday at 3pm. 

The event forms part of the “legacy” for former Spennymoor Town and Middlesbrough defender Bill Gates, who has sports-related dementia, and whose wife Dr Judith Gates is co-founder and chair of Head for Change. 

Dr Judith Gates

“When Bill received his diagnosis in 2017, we made two promises to him,” Dr Gates tells NR Times. 

“One was to optimise his life and do all we could to make his life as good as we could as a dad, grandad and great grandad, and the second was for his legacy, to do everything we could to be part of the solution for future generations of footballers and their families not to have to face this.

“The purpose of this match is to raise awareness of the dangers of heading the ball and to provide alternative discussion with purpose. It’s an experiment to see what the game will look like. 

“To be clear, Head for Change is not suggesting heading should be banned, that is a decision for football’s governing authorities, not for us. 

“But we want people to realise the impact. Bill was a Titan to me in his 20s, fit and indestructible, so if this disease can do this to him, it can happen to anyone.”

The match has attracted widespread media attention and comes after an array of stark academic findings, including the research from Professor Willie Stewart that footballers are up to five times more likely to suffer from dementia than the general population. 

“Part of why I co-founded Head for Change was to be part of the solution,” says Dr Gates. 

“We’re extremely aware that there is a lot of bashing going on and everyone is saying it’s someone else’s fault, but lessons must be learnt from the past. 

“For too long we have been assured that our brain was safe in our skull, but we are increasingly understanding how the brain works and how it can be damaged through contact sports. Education will continue to play a very important role in what happens going forward.”

The match itself – which will also be raising money for The Solan Connor Fawcett Cancer Trust – will be held at Spennymoor Town’s stadium, The Brewery Field. 

The town is where Dr Gates grew up and met her husband, and in a quirk of fate, Spennymoor Town’s chief executive Brad Groves used to work for Bill as a warehouseman when Bill owned a chain of sports stores. 

The club, alongside those playing in the match, have been hugely supportive of their ambitions, says Dr Gates. 

“We’ve been amazed at the extent to which they have stepped up, Spennymoor have been phenomenal. Brad has been so kind in offering whatever he can do to help. We are hugely appreciative,” she says. 

“The players taking part are excited to be part of it, they may not be able to use one of their many footballing skills but they can use the rest of them. 

“Spennymoor is a small town with a big heart and we are so pleased to be able to hold this match, and particularly here, at Bill’s first club.”

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Brain injury

Marching to a different beat

NR Times reports on how Chroma is helping amputees prepare for prosthetics through neurologic music therapy (NMT).

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