Monday 19 August 2019

One-size-fits-all approach to sport concussion may do more harm than good - doctor warns

Heavy price: Leinster and Ireland rugby star Dominic Ryan was forced to retire after a series of concussions. Photo: Sportsfile
Heavy price: Leinster and Ireland rugby star Dominic Ryan was forced to retire after a series of concussions. Photo: Sportsfile
Eilish O'Regan

Eilish O'Regan

The five-day rest rule for athletes who suffer concussion may do more harm than good for some people, a leading sports doctor has cautioned.

Dr Tadhg Crowley, medical officer with the Kilkenny hurling team, said the 'one-size-fits-all' approach to concussion treatment may not be right for everyone.

"Up to now, doctors have largely advocated rest and avoidance following a concussive episode. However, studies in the United States have shown that this does not necessarily help - and may actually have negative effects for some people," he told fellow doctors at the Irish Medical Organisation AGM.

He said a new treatment programme is now being trialled which involves two instead of five days' rest with a progressive return to activity.

"Concussion is a very serious condition, and further studies and research into how we treat it are hugely helpful.

"The primary goal is to get people back to living their lives fully after a concussive episode - be it playing sports or just going about their daily lives - and the Team approach's findings are very promising in that regard.

"The main thing is that each person is assessed individually. Some people may benefit greatly from returning to light exercise quickly, whereas others may need time off."

The Team approach (Targeted evaluation and active management) was pioneered by doctors at the University of Pittsburgh Medical Centre (UPMC) in Pennsylvania.

He said that in 2015, data from a randomised controlled trial was published which showed that, after a concussion, patients aged 11 to 22 who were prescribed five days' rest reported more daily post-concussive symptoms, compared with patients who were prescribed two days' rest with progressive return to activity.

He told the gathering that there is a concussion network of doctors through UPMC who have gone to Pittsburgh and studied how they could manage concussion in athletes.

The new system involves diagnosing the concussion and getting a detailed history examination of the athlete. They also carry out a neuro- cognitive test known as 'Impact'.

The idea is to work out a rehabilitation programmes which is individually tailored to the athlete diagnosed with concussion.

He said: "There is a network of physicians in Ireland who are using the Team approach to treating concussion through the UPMC.

"We can't stand still when it comes to figuring out how best to treat issues like this. This has been proven to help patients, which is our main priority."

Concussion in some sports remains one of the major worries of athletes concerned about repeated knocks to the head.

Research published in the 'The Lancet Psychiatry' journal has indicated that suffering concussion or other brain injuries as a young adult could increase the risk of dementia later in life by more than 60pc.It was carried out by the Washington School of Medicine.

Irish Independent

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