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A special online edition of The Journal of Science and Medicine in Sport which features research into head injuries and concussion in sport has been made free to access.

Since 2018, Sport Medicine Australia’s Journal of Science and Medicine in Sport has published 79 concussion or head-injury related articles.

The 42 articles in the special issue were chosen based on their citations, publication date and open access status, meaning they are free to access.

The Journal of Science and Medicine in Sport editor-in-chief Professor Tim Meyer said many of the articles are sport-specific, seeking to answer the question: “Do typical head impacts for a given sport have the potential to cause long-term brain damage?”

Professor Meyer said the research demonstrates that “we should not deviate from the immediate tasks of educating sport participants, coaches, parents and carers about the appropriate medical care of head injuries and the return-to-play (and -training) after an injury.”

Sports Medicine Australia Chief Executive Jamie Crain notes “Head injuries and concussion are of deep concern across the community and are taken extremely seriously by Sports Medicine Australia.

“It is important to have as much research as possible available to the public so participants, coaches, parents and spectators can understand the seriousness of head injuries and concussion, what can be done to minimise risks and to treat any injuries.

“The physical, mental and social benefits of sports far outweigh the risk of long-term damage from concussion and repeated head trauma when risks are adequately managed.

“Education is crucial to the management of those risks. And research is key to our understanding of those risks.

“Sports Medicine Australia welcomes any research. As evidenced by this special edition of The Journal of Science and Medicine in Sport on concussion, reliable data collection and research can take years to conduct and medical and scientific conclusions cannot be rushed.”

The sports covered by research in the special edition of The Journal of Science and Medicine in Sport include:

• Australian Rules Football
• Rugby
• Boxing
• Football
• Equestrian
• Skiing

Research articles in the special edition include:

Research needed to identify optimal rehabilitation and injury prevention strategies in Australian rules football
The research report ‘The impact of concussion on subsequent injury risk in elite junior Australian football athletes’ found the risk, anatomical location, and severity of subsequent injury in junior Australian footy players are similar following concussion compared to non-concussion index injuries. 

However, contact injuries are less likely after a concussion index injury. Due to the unique nature of concussion injuries, they likely require different rehabilitation considerations than other musculoskeletal injuries.

Future research should aim to identify optimal rehabilitation and injury prevention strategies following a concussion, the report said.

Women’s Rugby league 
Research titled ‘The propensity of non-concussive and concussive head contacts during elite-level women’s rugby league matches: A prospective analysis of over 14,000 tackle events’ found that the observed head contacts can inform interventions, primarily focusing on the tackler not contacting the ball-carrier’s head. 

The tackler’s head should also be appropriately positioned to avoid contact with the ball-carrier’s knee (highest propensity for concussion). The findings are consistent with research in men’s rugby. 

Law modifications and/or enforcement (reducing the number of un-penalised head contacts), concurrent with coaching interventions (optimising head placement or reducing the head being contacted) may help minimise head contact risk factors for women’s rugby league, the report found.

Tackling changes could help minimise concussion in elite rugby union
The research report Can tackle height influence head injury assessment risk in elite rugby union? found that concussion prevention strategies should place emphasis on tackling lower risk body regions such as the mid- and lower trunk.

Amateur boxers need better prevention from head injuries
Amateur boxing athletes sustain, on average, one injury every 2.5 hours of competition and every 772 hours of training, the report ‘Epidemiology of injuries in amateur boxing: A systematic review and meta-analysis’ found.

The report said: “There is a need for identifying injury mechanisms and modifiable risk factors that can be targeted by preventive measures to reduce the burden of injury in amateur boxing.”

Targeted concussion awareness campaigns needed for community level cricket
The article ‘Concussion assessment and management - What do community-level cricket participants know?’ found satisfactory awareness of concussion among community cricket players and officials but there were discrepancies among players on some aspects of awareness of concussion guidelines. 

The researchers found that “targeted campaigns are needed to further improve concussion recognition and treatment at community-level cricket, so all participants play a role in making cricket a safe sport.” 

Increasing players’ familiarity and experience in using the concussion guidelines is warranted, the report said. 

Parents’ stress levels affect children’s post-concussion recovery 
Research titled ‘Higher parental stress is significantly related to longer clinical recovery times in concussed children’ found that recovery time is significantly longer in concussed children whose parents are experiencing higher levels of stress, but not pre-existing anxiety, following injury. 

The research found that parental stress varies throughout recovery, with stress generally higher in the acute post-injury period. 

Clinicians should monitor parental stress post-concussion when possible, the report said.

Neck strength important to rugby and football (soccer) players concussion risks
The research ‘Neck strength and concussion prevalence in football and rugby athletes’ found that normative neck strength data can form important reference values for rugby and football athletes from adolescence into adulthood. 

Male rugby athletes with a previous history of concussion demonstrated strength imbalances of their neck musculature (lower flexor/extensor ratio), with this finding having potentially important implications for training protocols and injury prevention initiatives, the report said.

Equestrians need concussion awareness campaign
The research paper ‘Concussion knowledge, attitudes and behaviour in equestrian athletes’ found that knowledge of and attitudes towards concussion were positive among equestrians. However, there were knowledge gaps and discrepancies between some attitudes and behaviour on some aspects of concussion.

Targeted campaigns to promote awareness of concussion and improve recognition and onward management are needed, the report said. Education related to equestrian activities such as helmet use and injury mechanisms is needed to change behaviour and minimise the risk of injury.

Concussion and sleep quality
The research article ‘Early physical activity after concussion is associated with sleep quality but not dizziness among adolescent athletes’ found that athletes recovering from concussion who had no physical activity reported worse sleep quality and slower single-task tandem gait.

Access The Journal of Science and Medicine in Sport’s special online edition featuring research into head injuries and concussion in sport. 

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