A joint venture between the Insight Centre for Data Analytics and the IRFU has produced the first study to examine the relationship between a player’s dynamic balance skills and their risk of concussion.

The study used a novel digital biomarker to identify poor balance which, the study has found, may increase concussion risk by a factor of three.

One hundred and nine elite male adult Irish Rugby Union players were tested for dynamic balance performance ahead of the 2016/2017 Rugby Union season. The tests were carried out using miniature motion sensors and the results were assessed using advanced analytical approaches that were developed in the Insight Centre for Data Analytics, University College Dublin.

This is the first study to identify a risk factor for concussion in Rugby Union that can be identified and modified through targeted balance training interventions.

Professor Brian Caulfield, Insight Centre for Data Analytics, said: “These findings add significant value to the current literature in sport-related concussion; contributing an increased understanding of why individuals may be at risk of concussion. This study has significant implications for both research and clinical practice as our results have demonstrated that Rugby Union players with sub-optimal dynamic balance performance, as measured using a wearable inertial sensor, were three times more likely to sustain a concussion in the following season. Furthermore, the dynamic balance test can be administered in the field using an inexpensive sensor and a mobile app.”

The Insight Centre is a Science Foundation Ireland Research Centre.

Rod McLoughlin of the IRFU, collaborators in the research, welcomed the potential to improve outcomes for players at all levels. “These findings would suggest that targeted movement control interventions may reduce an individual’s risk of sustaining a subsequent concussion, decreasing the burden of injury and protecting player welfare.”

Previous studies have shown that players who have previously sustained a concussive injury are more likely to suffer further concussions. One in five players in this study reported previous concussions. However, even when controlling for injury history, players with sub-optimal dynamic balance were still three times more likely to suffer concussion the following season.

“It is well established that the tackler is at a higher risk of sustaining a concussion than the ball-carrier, with poor tackle technique associated with concussive injuries in elite junior Rugby Union,” according to William Johnston, PhD student in the Insight Centre for Data Analytics and lead author on the paper. “If an individual displays reduced dynamic balance performance, they may have poorer control and awareness of their body, increasing their risk of entering a vulnerable position and sustaining a concussive injury. The findings of this exploratory study are significant as dynamic balance is a modifiable intrinsic risk factor, with balance and motor control training interventions frequently demonstrating their efficacy in improving balance and reducing musculoskeletal injury.”

Researchers in the study hope that early identification of such modifiable risk factors may allow medical teams to introduce appropriate targeted interventions to reduce player’s risk of sustaining a concussion in Rugby Union. The finding in this study suggest that movement control training could protect against concussion risk, though this needs to be confirmed in future research. Testing of this hypothesis, as well as extending the research to male and female participants across a range of sports, is currently being addressed in follow-up collaborations between the research team in University College Dublin and colleagues in the University of Wisconsin-Madison in the USA, as well as through an IRFU supported study at Ulster University.

The findings are published in the current edition of the American Journal of Sports Medicine https://doi.org/10.1177/0363546518812820

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