Rugby’s governing authorities are being urged to take “urgent preventative action” to protect players at all levels of the sport after new research suggests the game may have been safer in the pre-professional era.
The BRAIN study, published today, found that former elite rugby players who experienced three or more concussions during their career did not have worse cognitive function before the age of 75 than those who had experienced no, or just one or two, concussions.
The study found no overall group association between concussion history and worse cognitive function, but did find that 29 per cent of over 75s who had sustained three or more rugby-related concussions during their career had significantly worse cognitive function.
However, results from the BRAIN study – funded by The Drake Foundation, which worked with 146 former elite rugby players in England aged 50 and over, most of whom played in the pre-professional era – call into question whether safety standards in the sport have worsened since the game became professional.
Several retired players from the modern era have recently been diagnosed with early-onset neurodegenerative disease and likely Chronic Traumatic Encephalopathy (CTE).
In addition, the neuroimaging results of the Drake Rugby Biomarker Study, published earlier this year, found that 23 per cent of current elite adult rugby players tested had abnormalities in brain structure, and half showed an unexpected change in brain volume.
The Foundation has also been vocal in its campaign to make recommendations around safety in rugby and football enforceable rules, and is now calling for further immediate emphasis on player welfare.
“These findings are broadly reassuring for players from the amateur era,” says Lauren Pulling, CEO of The Drake Foundation.
“However, given the findings of the Drake Rugby Biomarker Study and recent cases of early-onset brain disease in ex-players from the professional era, the new study results do call into question how long-term health might differ in players from the modern era.
“The evidence we have so far suggests that the sport may actually be travelling in the wrong direction in terms of player welfare and brain health.
“In addition to further research, we therefore also urge the sport’s governing bodies to review the modern game’s laws and protocols and take urgent, preventative action to universally reduce players’ exposure to head impacts both in matches and training.”
Additional research carried out this month on behalf of The Drake Foundation by Censuswide, via an online survey of 508 respondents in the UK who are involved in rugby union, found that 62 per cent of adults who either play amateur rugby or have a child who plays rugby are concerned about the long-term effects of the sport on their or their child’s brain health.
This figure rises to 73 per cent for parents who do not play the game themselves, but who have a child that does.
Over 60 per cent agree that rugby has become a more dangerous sport at all levels since it turned professional in 1995, whilst 66 per cent believe that rugby union would be safer if fundamental law changes were introduced to better reflect the way the sport was played in the pre-professional era.
James Drake, founder of The Drake Foundation, says: “As a passionate sports fan who loves rugby, I’ve witnessed first-hand the way the game has evolved since turning professional.
“In my view it’s a sport that has become ostensibly less safe for the players involved and my concerns are reflected by our research this month, which reveals 61 per cent of adults who either play the game or have children that do, are concerned about the sport’s long-term effect on brain health.
“A further two thirds of adults believe the sport could be made safer if law changes were introduced to return it to the game as it was played in the amateur era. The Drake Foundation is calling on rugby’s authorities to give this immediate consideration to protect the sport we love and the current and future generations who play it.”
The BRAIN study is the first to carry out detailed measurements of cognitive function in a large number of former players and to relate this to their concussion and playing history.
It was conducted by the London School of Hygiene & Tropical Medicine, Queen Mary University of London and the Institute of Occupational Medicine with researchers from UCL and the University of Oxford, and with assistance from the Rugby Football Union (RFU).
It is also the first to include substantial numbers from the over-75 age-group. Previous studies which have focussed on younger players have found little or no association between concussions and reduced cognitive function.
ABI strategy confirmed by Government
Huge breakthrough in support for people with brain injuries comes after Chris Bryant MP introduced the ABI Bill
The Government has today committed to producing a strategy to deliver better support to people living with acquired brain injury (ABI), following efforts from MP Chris Bryant and an array of charities and leading figures to force them into action.
In a statement, it was confirmed a strategy will be drafted with a call for evidence being launched early in the new year to help shape its development.
Gillian Keegan MP, Minister for Care and Mental Health, said the development of the strategy would be co-chaired by herself and Mr Bryant, with senior officials in all relevant Government departments invited to join the board.
“Following publication, the strategy will be kept under review and may be revised periodically to ensure that it continues to reflect the priority areas and actions needed to best support people living with ABI and their families,” the statement said.
The move by the Government marks a huge step forward in ABI provision, following years of campaigning from charities and survivors for more support. Mr Bryant recently introduced a Private Members Bill with the aim of forcing the creation of such a strategy, which was due to have its second reading in Parliament tomorrow.
Mr Bryant – chair of the All Party Parliamentary Group (APPG) on ABI and a tireless campaigner for the cause – had called on the Government to take action to ensure a more joined up approach from Government departments in supporting individuals and families affected by brain injury.
Last month, he delivered a letter signed by over 200 MPs, charities, brain injury survivors and other providers to 10 Downing Street, calling on the Prime Minister to take action. Following that, Boris Johnson confirmed in Parliament that the Department for Health and Social Care would be looking at the development of such a strategy.
It has also been supported widely by the public and via social media.
But today’s confirmation is a huge step forward and will ensure the development of an appropriate strategy, with input from families and professionals across the world of ABI.
Announcing the development on Twitter, Mr Bryant said: “ The Government has just announced it will draft a strategy on Acquired Brain Injury, set up an ABI programme board which will be co-chaired by Gillian Keegan and me, and will call for evidence very soon.
“So my ABI Bill won’t be needed. Many thanks to all who’ve helped!”
Charities who have been vocal in their support of Mr Bryant’s Bill were keen to celebrate the move, which comes after years of campaigning.
UKABIF hailed the announcement as “a gift” and the Disabilities Trust said it was “just amazing”.
The Child Brain Injury Trust added: “Fantastic news to hear. A strategy for ABI has been needed for so long. We are thrilled!”
UEFA concussion charter urges protection and education
The importance of educating players, coaches, referees, doctors and the public about dangers of concussion in football is highlighted
A European-wide football concussion charter has been launched, stepping up efforts to safeguard players and urging the education of those involved in the game around the dangers of impacts to the head.
UEFA has launched its concussion charter, which will apply to all teams taking part in men’s and women’s club and national team competitions across Europe.
The charter aims to reinforce the importance of good practice in concussion management and highlights the concussion procedures that should be followed.
It also promotes the education of players, coaches and staff about the concussion procedures in force at UEFA games. Team doctors are being asked to organise specific education sessions to brief players, coaches and staff about the concussion procedure to be followed at UEFA matches.
Furthermore, its 55 member associations are ‘strongly encouraged’ to deploy where possible, a medical video review system at their stadiums to enable immediate and informed injury assessments.
UEFA will facilitate the installation of the system with the host broadcaster. Home teams using a medical review system should offer the visiting team the same system.
Club and national teams are being urged to sign the charter to underline their commitment to safeguarding the health of their players.
In doing so, the signatories pledge their full support for UEFA’s guidance on how to recognise and manage a head injury from the time of injury through to the safe return to football.
“Everyone should know how to react and what to do,” said Tim Meyer, UEFA Medical Committee chairman.
“Concussion is undoubtedly a serious injury which needs to be managed and treated properly.
“The health and safety of any players taking part in Europe’s club and national team competitions is of paramount importance not only to UEFA, but also to national associations across the continent.
“Although research studies report a low incidence in football, everyone should know how to react and what to do in the event of a concussion on the pitch.
“By signing this charter, clubs and national teams will demonstrate their support for UEFA’s concussion awareness activities – and take a considerable step forward in helping to protect their players.”
The measure is the latest stage in efforts to safeguard players, following steps including UEFA’s implementation of a keynote concussion awareness campaign in 2019 and the Premier League becoming the first competitive league in the world to introduce concussion substitutes.
UEFA’s head injury procedure is:
• In the event of a suspected concussion, the referee will stop the game to allow the injured player to be assessed by the team doctor. Players should remain calm during the situation and not interfere with the assessment.
• The assessment should in principle not take more than three minutes, unless a serious incident requires the player to be treated on the field of play or immobilised on the field for immediate transfer to hospital.
• If the assessment cannot be made after the three minutes and/or a suspicion for a concussion arises, the player should not be allowed to continue playing.
• A player suffering a head injury that requires assessment for a potential concussion will only be allowed to continue playing after the assessment, on specific confirmation by the team doctor to the referee of the players fitness to do so.
The decision remains entirely with the team doctor. Coaches, referees and players are not allowed to interfere in the assessment and decision of the doctor.
Calvert Reconnections delivering positive outcomes
Only months after opening, patients are already realising the benefits of the groundbreaking neurorehab centre
Participants at ground-breaking neurorehabilitation centre Calvert Reconnections are already realising the benefits of the centre’s unique approach.
Calvert Reconnections opened its doors in June 2021, bringing a new, goal-focused, outcome-based approach to ABI rehabilitation.
Five months on, feedback from participants is now demonstrating how Calvert’s programme is delivering tangible results and pathways back to everyday life.
“Our programme is transforming the lives of our participants,” explained Claire Appleton, Head of Service at Calvert Reconnections.
“One of our recent residents said that his stay at Reconnections had transformed his quality of life, enabling him to return home, to his wife, rather than going into permanent 24-hour care.
“Such was the life-changing progress of another resident, he recently walked to the summit of Latrigg having only been able to walk a few hundred yards when he first came to stay with us.
“The whole team is hugely excited about the difference we are making to people’s lives.”
During meetings with other residents, Calvert Reconnections received the following feedback:
- “I feel comfortable here, all the staff are really nice, they put up with me being confused or disagreeing, they are very patient.”
- “You have made me realise you can get me closer to how I was before my accident. I accept who I am, I couldn’t do that before, I am OK with myself now.”
- “I now have confidence to go about my ways.”
- “You have improved my ability in lots of ways.”
- “I cannot think of anything you could do differently or improve.”
- The staff have a great can-do attitude.”
- “I feel like I am getting better, getting fitter every day – my friends say I am getting better.”
- “Doing different things all the time matters.”
- “The specialist bike, the other people and the staff are all great.”
- “I have a special bond with one of the participants – we love the banter.”
- “It’s good to feel fitter again.”
- “The staff are prepared to alter the programme with the weather and any other reasons.”
- “It’s the people – we all keep an eye out for each other.”
- “The food is great.”
- “I have a lot of trust. I am asked to do things which seem difficult but it’s been possible, I’ve managed to be a metre or 2 off the ground on the climbing wall.”
- “The cycling was good.”
- “I am working on my dorsiflexion and this is brought in to my activities each day.”
- “Reconnections has given me the opportunity to achieve my independence.”
- “You asked me how we could improve Reconnections. I have no criticisms – this is different to other rehab units, in a good way.”
- “This is the best place for me to be.”
Calvert Reconnections has also recently announced its winter activity programme which includes walking and star gazing, bushcraft sessions, environmental art, photography projects, rock climbing (Calvert sports hall available), canoeing (Calvert swimming pool available), equine therapy, basketball (Calvert sports hall available), curling (Calvert sports hall available), badminton (Calvert sports hall available), sledging, cycling, ghyll scrambling and orienteering.
The centre has also been shortlisted for Best Initiative in Care at the Caring UK Awards.
Calvert Reconnections has places available now. For further details, visit here
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