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Concussion management improvements

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Ahead of the new Premiership Rugby season, further enhancements have been made to the way concussion will be managed in the professional club game in England.

Building on learnings from the 2015 Rugby World Cup, which had the highest and most effective player welfare standards operation for any rugby event to date and where 50 per cent of concussion cases were identified by real-time video review of the head injury event by medical staff, Aviva Premiership Rugby will become the first rugby league in the world to trial real-time pitchside concussion video review to help team medical staff better identify players who have been exposed to head injury events.

Funded by the 12 Premiership Rugby clubs, delivered by Premiership Rugby and supported by the Rugby Football Union, the innovative myplayXplay system will be used in all 135 Aviva Premiership matches this season plus all other senior Premiership club  home fixtures in domestic competitions.

“We have made huge progress on concussion management in the last few years but we know we have to continue to innovate and develop our systems as player welfare is our number one priority,” said Corin Palmer, head of rugby operations at Premiership Rugby.

“Premiership Rugby have sourced and funded the myplayXplay real-time concussion surveillance solution for Premiership players in England to ensure that players receive the best possible support from the sidelines.

“The myplayXplay system is ground-breaking and allows club medical staff to review and analyse injuries on an iPad moments after they occur. This addition to the sideline toolkit improves their ability to diagnose injuries correctly during a match.

“I can only applaud our clubs for the way they have embraced this new system. They are committed to improving player welfare and this is another example of this.

“This is destined to become a vital tool to support proactive medical efforts. In its inaugural season of use, using myplayXplay’s technology will add significant value in ensuring player safety and welfare.”

A Pitchside Video Reviewer (PVR) will be provided by each Premiership team. The PVR, a member of the club’s medical team, will monitor game footage in real time and will be responsible for referring any suspicious head injuries to the team doctor for review.

Video footage of any suspicious head injury events in real time will be captured and clipped by the PVR and reviewed by the team doctor to assess if a player should be immediately removed, on a permanent basis or temporarily replaced for an assessment using the HIA process.

In addition to this initiative designed to improve the recognition of concussed players, the RFU and the English professional club game is investigating the value of the King Devick (KD) test, an eye scanning test in the identification of concussed players. The King-Devick test, developed in conjunction with the Mayo clinic in America, tests the speed and accuracy of an individual’s eye movements as they track and read out a sequence of numbers presented to them on an iPad. A player’s speed and accuracy are then compared to their performance recorded in the pre-season.

The test will be conducted on all players undergoing a Head Injury Assessment in all Aviva Premiership Rugby, and Green King IPA Championship matches this season. The King-Devick test has shown real potential in identifying concussed athletes in a number of other studies but has not been investigated to date in professional rugby.

World Rugby, who are supportive of the research project, have approved an extension of the 10-minute HIA to 13 minutes in these two competitions to allow the King-Devick test to be performed at the end of the standard HIA process. For this season the King-Devick test will be conducted alongside the HIA solely for research purposes and will not influence the result of the HIA assessment. If it is shown to be an appropriately sensitive and specific test there is the potential for it to be added to the HIA assessment in the future. Because the test does not need to be supervised by a medical practitioner it has significant potential to improve concussion assessment in the future in both the professional and community games.

For the third successive season, a mandatory concussion education programme is again being delivered to around 1500 England representative men’s and women’s players, Premiership and Championship players, coaches and support staff and Premiership and Championship referees. This year the programme includes face to face sessions led by club doctors as well as completion of the on-line concussion awareness module for new joiners.

Dr Simon Kemp, chief medical officer for the RFU, commented: “These projects show English professional rugby’s strategic commitment to concussion education, identification and research. All three projects have been developed as a result of collaboration between PRL, RPA and the RFU and a wide range of external independent medical professionals and scientists. They will provide an enhanced and streamlined process for delivering the 4R’s (recognise, remove, recover and return) in professional rugby union.

Ivan Reel, CTO of myplayXplay said: “Combining the world of sports with the newest technology of streaming video to mobile iPad devices is a great combination. We stylised our innovative iOS APP for Premiership Rugby and they will benefit from being able to capture, record and take advantage of video live for the purposes of player welfare. Simple yet effective technology can be used in addressing key and critical video review/replay needs."