The Use of Sideline Video Review to Facilitate Management Decisions Following Head Trauma in Super Rugby.

Journal: Sports medicine - open

Volume: 4

Issue: 1

Year of Publication: 

Affiliated Institutions:  Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. Andrew.Gardner@neurogard.com.au. HeadSmart™ Sports Concussion Program, Head Office Helensvale Road, Helensvale, Gold Coast, Australia. Australian Rugby Union (ARU), Moore Park, NSW, Australia. Emergency Medicine Research in Sheffield Group, School of Health and Related Research, University of Sheffield, Sheffield, UK. School of Management Studies, Faculty of Commerce, University of Cape Town, Cape Town, South Africa. Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, VIC, Australia.

Abstract summary 

Sideline video review has been increasingly used to evaluate risk of concussive injury during match play of a number of collision sports, with the view to reducing the incidence of match play concussion injuries. The purpose of this study was to evaluate the effectiveness of sideline video review for identifying and evaluating head impact events in Rugby Union.All Australian teams' 2015 Super Rugby season matches were studied. Meaningful head impact events (HIEs) were identified, comprising events identified and acted upon during matches and events identified through a post-season retrospective review. Video footage of each HIE was coded by two experienced independent sports medicine clinicians to evaluate management decisions made by match-day (MDD) and team doctors (TD). HIE incidences for matches with and without sideline video were compared, and the agreement between game-day video interpretation and the independent clinician opinion calculated.Seventy HIEs were identified in 83 matches (47 identified during matches and 23 identified post-season), equating to 42.5 HIEs per 1000 player match hours. When video review was available, an unnoticed HIE occurred once every 4.3 matches, compared to once every 2.3 matches when the sideline video review was unavailable. Of the 47 identified in-match HIEs evaluated by TD and MDD during the season, 18 resulted in an immediate and permanent removal, 28 resulted in temporary removal for an off-field assessment, and one resulted in the player continuing the game. Game-day head injury assessment process video decisions agreed with the independent clinician view in 72% of cases, κ = 0.49 (95% CI 0.38-0.59, weak agreement).These findings suggest that access to sideline video review is an important supplementary component to identify potential concussions; however, there is a critical need for improved systems and processes to reduce the likelihood of missing an incident.

Authors & Co-authors:  Gardner Andrew J AJ Kohler Ryan R McDonald Warren W Fuller Gordon W GW Tucker Ross R Makdissi Michael M

Study Outcome 

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Statistics
Citations :  Gardner AJ, Iverson GL, Williams WH, et al. A systematic review and meta-analysis of concussion in rugby union. Sport. Med. 2014;44:1717–1731. doi: 10.1007/s40279-014-0233-3.
Authors :  6
Identifiers
Doi : 20
SSN : 2199-1170
Study Population
Male,Female
Mesh Terms
Other Terms
Concussion;In-match concussion management;Rugby;Video analysis
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
Switzerland