Research leads to enhanced CFL concussion guidelines

UAlberta medical researcher Dhiren Naidu is also the team physician with the Edm

UAlberta medical researcher Dhiren Naidu is also the team physician with the Edmonton Eskimos, the head physician for the Edmonton Oilers and a specialist in concussions.

Study tests how much CFL players and their university-level counterparts know about concussions--and how to deal with them.

Research from the University of Alberta shows Canadian Football League players are more likely than university-level players to value medical tests after concussions. But the professional athletes are more apt to incorrectly believe it’s OK to return to the sport within 24 to 48 hours if they have no symptoms.

The study looked at how CFL athletes fared against their university-level peers when it came to concussion knowledge, and whether a one-hour concussion education program improved the two groups’ knowledge. All of the CFL players realized the importance of seeking medical tests after a concussion, versus 67 per cent of university-level football players. On a different issue, 44 per cent of pro football players incorrectly thought it was safe to return to the sport one to two days post-concussion if they had no symptoms, whereas 26 per cent of their university peers believed this practice was safe.

“You can still be healing from a cognitive perspective even though you feel normal,” says Dhiren Naidu , lead researcher from the Faculty of Medicine & Dentistry , who worked with colleagues from the Faculty of Education on the projects.

“Research shows 85 to 90 per cent of adults recover from a concussion within 10 days. Athletes usually follow a paced ‘return-to-play protocol’ once they are no longer displaying any concussion symptoms. Just because athletes feel better one to two days after a concussion, that doesn’t mean they’re healthy enough to go back and start hitting or taking a hit again.”

A total of 68 university athletes and 72 CFL athletes took part in this study, which involved answering a questionnaire before and after a one-hour education session on concussions. Results showed most players knew how to manage concussions and what the hallmark symptoms were. And after the session, players were more apt to understand two key pieces of information: concussions can stem from blows to any part of the body, and MRI or CT imaging doesn’t always detect concussions.

Last season the CFL implemented annual concussion education sessions for athletes. These results confirm the effectiveness of the education sessions and underscore the importance of continuing to educate athletes on the topic of concussion.

Naidu, a physician who specializes in concussions and works in the Division of Physical Medicine and Rehabilitation, says he was surprised that more players weren’t aware of those two key facts about concussion.

“These two items have been the mainstays of concussion education for years, so I was surprised more athletes weren’t aware of these facts. You can get hit anywhere on the body and get a concussion, because it’s about the force being transmitted to the head. You don’t need a hit to the head to have a concussion.”

A second study led by the same team looked at concussion history and symptoms in university-level athletes. The results showed football players fared the worst when it came to experiencing a plethora of symptoms and having more than one concussion. Football players had poorer results in visual memory tests and were more apt to report symptoms such as headaches, fatigue, drowsiness, irritability and feeling more emotional. Sixty-five per cent of hockey players, 56 per cent of football players and 50 per cent of soccer players reported experiencing concussions in the past. Hockey players were also more apt to experience amnesia post-concussion. A total of 274 male athletes took part in this second research study, including 155 football players, 67 hockey players and 52 soccer players.

The findings from these studies were presented at a Canadian Academy of Sport Medicine meeting in April and published online in the Clinical Journal of Sport Medicine earlier this spring.

Naidu is continuing his research in this area and would like to study how athletes who have had multiple concussions fare on neuro-psychological tests five years later. He wants to know whether their baseline test results change as they have more concussions.

Naidu is the author of the CFL’s player education session and was part of the CFL medical advisory panel that wrote the concussion guidelines that will be implemented in the league this year. He is also the team physician with the Edmonton Eskimos, the head physician for the Edmonton Oilers, and a specialist in physical medicine and rehabilitation and sport medicine.

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