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Brain injury

Rugby stars join Shearer in dementia in sport fight

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Two world-renowned former rugby stars have joined with Alan Shearer in stepping up the fight against dementia in sport. 

Shane Williams, the all-time record try scorer for Wales, and World Cup-winning England lock Ben Kay are among 50 former elite rugby players to have backed the prevent PREVENT:RFC project, the latest phase of the Sport United Against Dementia campaign. 

It builds on the existing UK and Ireland-wide PREVENT project, which also includes an informal pilot study with footballer players, including Alan Shearer, the Premier League’s record goalscorer turned BBC pundit. 

Recently, the former England captain presented the BBC documentary ‘Alan Shearer: Dementia, Football and Me’, which investigated the link between the game and brain injury. 

The large-scale PREVENT:RFC research, funded by the Alzheimer’s Society, will look at vital unanswered questions, such as whether elite rugby players show more early warning signs of dementia than the general population, and if so, why this is the case.

“It was really important to me as a rugby player to take part in this study. There has been a lot of media coverage around this topic lately and as a result, I know lots of players are worried about their dementia risk,” says Kay. 

“Hopefully, by doing this research now, we can get a better understanding of this issue and make a real difference for the future.”

Shearer adds: “I’ve been following the sport and dementia conversation for years now – and there’s still more I want to learn about the science behind the stories in the news. 

“I know the risk of dementia is something that worries many players, so work directed to understanding the earliest stage of dementia is incredibly important, and this study in rugby players will add to our understanding of that in sport.”

PREVENT:RFC will be based in Edinburgh with Professor Craig Ritchie, PREVENT’s principal investigator, working in collaboration with Professor William Stewart from the University of Glasgow. Previous research led by Professor Stewart revealed that professional footballers appear to be five times more likely to die from Alzheimer’s disease than the general population. 

Through committing a further £250,000 to research, the PREVENT:RFC project involves further participants to the 700 people already enrolled in PREVENT, and will undergo an initial assessment—involving physical health checks, brain scans, memory assessments, lifestyle questionnaires and sample collections – and then return for another visit two years later.

PREVENT – part of the groundbreaking Sport United Against Dementia campaign, which continues to unite the collective power and reach of sport for the first time to improve the lives of current and former players of all levels – is funded by the Alzheimer’s Society for over seven years and follows people aged 40 to 59, aiming to find ways of detecting dementia before symptoms appear, and stopping people from developing the disease. 

It takes place at the University of Edinburgh, Imperial College London, Trinity College Dublin, University of Cambridge and University of Oxford.

Dr Richard Oakley, head of research at Alzheimer’s Society, funder of the PREVENT study, says:

“This is a desperately needed, exciting world-class research study looking to answer questions around brain health in elite rugby players. 

“There’s been a lot of attention focused on sports players who’ve developed dementia, and that’s raised important questions about whether playing sports like football and rugby increases the risk of developing the condition. 

“While we’re seeing some evidence of a potential link, the latest findings don’t explain why sports players may be at a greater risk of developing dementia.

“Alongside launching Sport United Against Dementia, we’re really excited to fund this new phase of the PREVENT study – we hope it’ll provide the answers so many people are looking for.” 

Professor Stewart, consultant neuropathologist and honorary professor at the University of Glasgow, adds: “It is vitally important we better understand the links between sports such as football and rugby and dementia, so we can better protect players from any risks they may face.

“Previous research led by our team at the University of Glasgow demonstrated the increased risk of neurodegenerative disease in former professional football players. 

“I am delighted to be a part of this latest PREVENT study into professional rugby players, and the adjoining pilot looking at professional football players, so we can bring more insight to this important research area.”

Brain injury

New cycle helmet test discovers true level of protection for cyclists

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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

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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

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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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