Concussion in youth rugby: a multiple component study investigating the effects of concussion in adolescent rugby players and their recovery

Abstract

Introduction: Sport-related concussion (SRC) is a complex process affecting the brain induced by traumatic biomechanical forces (1). Clinical recovery in adults typically takes 10-14 days (2), but recovery in paediatric patients is more unpredictable (3-8). Factors like female sex, younger age, and previous concussions increase the risk of prolonged recovery (9). The overarching aim of this thesis was to understand when adolescents recover from SRC.

Methods: This thesis comprised of three strands. Strand 1) A literature review of adolescent SRC established the research framework. Strand 2) Three cross-sectional studies involving 113 male and 36 female adolescent rugby players, were conducted using various concussion assessment methods (PCSS,CP-Screen, PHQ-9, GAD-7, PFAB-TBI, QYBT, PLR) at baseline during the 2022-23 season. The results were stratified by sex and concussion history. Strand 3) Concussed players were then followed longitudinally at regular intervals over 6 months using a repeated measures design.

Results: Strand 1) found a lack of innovative quantitative technology for concussion assessment, limited research on adolescent females, and short follow-up periods. Strand 2) found that adolescents rarely scored 'zero' on self-reported measures. Significant differences were found between those with and without a concussion history and between males and females on several baseline measures. These findings align with current evidence. Strand 3) found that the median 'me to return to baseline on individual measures was between 14 and 23 days, while the combined metrics suggested a median return to baseline around day 180. All players returned to full, unrestricted play by day 23.

Conclusions: This research highlights the prolonged and unpredictable recovery from sport-related concussion in adolescents, underscores the need for individualized baseline testing, and emphasizes the importance of including adolescent females and extending follow-up periods. Further investigation into innovative technology for concussion assessment is crucial.

Thesis is embargoed until 31st December 2026.

Date of Award	Dec 2024
Original language	English
Supervisor	Mark Matthews (Supervisor) & Chris Bleakley (Supervisor)