Leinster Rugby & Trinity College Expand Concussion Project
June 29, 2017 11:45 am Marcus Ó Buachalla
In light of the work already underway by Leinster Rugby in conjunction with Trinity College Dublin, the Co-Chairs of the CARE Consortium, Steve Broglio and Mike McCrea, approached Leinster with a view to discussing the work as part of a wider concussion research piece.
The CARE Consortium – Concussions Assessment, Research and Education (‘CARE’) – was established in the US by the National Collegiate Athletic Association and the Department of Defence in response to concerns arising from concussive episodes in sport, in the military and in society at large.
The ultimate aim of their study is to find an objective biomarker of physiological recovery for concussion and the hope is that Leinster Rugby can play a role in that research.
Leinster Rugby Head of Physiotherapy Garreth Farrell explained the work already underway with Trinity College Dublin and the role that the CARE Consortium can play in that work.
“We’ve been working with Trinity College for a while now and looking at the science behind concussions and in particular the use of blood analysis to see if there are any blood biomarkers we could use that would indicate when a player was concussed and just as importantly, when they had recovered from concussion.
“But we were really a small player in this on a global scale and it was a small sample size relatively speaking of Leinster players. But the CARE Consortium in the States have a reputation in this field already not only in terms of blood biomarkers but also the neuropsychological testing in the area and are already working with a database that far outweighs what we have at our disposal. We want to make our research as robust as possible and it’s perfect in that regard.”
So what do they hope to achieve?
“The ‘holy grail’ would be to develop a pin prick blood biomarker test and that is what we are working towards but the reality is that it is a very complex multifactorial area and there isn’t one test that is fool proof for 100% of the cases.
“But a blood biomarker test would be a hugely useful tool in the diagnosis of concussion because ultimately as sports medicine practitioners, we all put the health and welfare of our players first and anything that can help us in that regard is a huge plus.”
The impact on the Leinster players is quite invasive but without them it would not be possible as Farrell explains.
“We’ve been like vampires floating about getting samples from them but they’ve been brilliant. They are fascinated by the research first and foremost so they understand why it needs to be done and we have been very active in collecting blood samples at the start of the season, mid-season and of course at the end of the season and building up that data of base level readings on a player by player and on a season by season basis.
“But obviously the key element then is taking the samples when players are concussed and of course when they have been cleared to return to play. The samples are all sent to a laboratory in Denmark and then are added to the wider research piece.”
It is all part of the ongoing work by the IRFU and the four provinces in dealing with concussion.
“Concussion is at the front of everybody’s mind now and I think that is brilliant. The public have a greater understanding, the media, players, coaches, everyone and that is a good thing.
“How we look after players has progressed hugely in the last few years and let’s not forget as part of the medical team in Leinster we know these lads, we look after these lads like you would your own. Your brother, your father, your mother and you want that standard of care for them that you’d expect for your own family.
“Once upon a time the game was seen as the all-important but now we have parameters in place that safeguard the player in the whole equation and he or she can be removed from the field for evaluation. Is it 100% the answer, no, but it is certainly better than not having it there and it is a world away from what we had and that is hugely positive.
“But can we do more, learn more? Of course we can and that is what the work with Trinity and now the work with the CARE Consortium is all about.”
Steve Broglio, Co-Chair of the CARE Consortium was in Leinster HQ recently summarising the research to Trinity College staff and Leinster medical staff and presenting findings from their 2,000 concussions analysed to date.
Broglio is Associate Professor at the University of Michigan in the School of Kinesiology and Departments of Neurology and Physical Medicine and Rehabilitation and has been working in concussive research for over 15 years.
“I was delighted when Fiona Wilson in Trinity invited me over to discuss some of our work to date with our friends in Leinster.
“Most of our work at the CARE Consortium is at the collegiate level so American Football, ice hockey are our two big sports but our belief is that biologically there should be no difference between a concussion that affects a rugby player as opposed to an ice hockey player.
“So we have learned some valuable lessons to date in our research but we are constantly looking to evolve the data or add new elements and I think working with Fiona and the team in Trinity and a professional rugby team like Leinster with players of all ages from late teens to early thirties is a huge bonus.”
Broglio is also enthused by what he has seen so far from the research and the potential outcome.
“The biomarker work is cutting edge. The real issue I think we can all agree on is diagnosing the injury in real time, when it happens, within seconds so if we can find that one biomarker that shows up in the blood seconds after injury then that’s a game changer.
“You can get the guys out, get them the medical care that they need and then get them back after an appropriate amount of rest.
“Some of the work that we have carried out to date in the States has 30,000 in one research project and then about 2,000 that we are working on blood biomarkers and then the rugby group that we are now working on feeding into those samples.
“But you need those numbers. Large numbers of cases and looking for the smallest of things but we are all working very hard to make that a reality.”
Like Farrell before him, Broglio also has the player and the participant at the heart of his work.
“We all know it’s no good sitting on your couch, doing nothing and the bad outcomes that can come from that so for us we want to keep people playing, enjoying the positive outcomes that come with being active and playing sports and to stay healthy for the rest of their lives. That’s the goal.”
Both Broglio and McCrea will be over in Ireland again in the coming months to offer further insight as the work between Leinster Rugby and Trinity College continues.
The final word is with Farrell and the possibilities going forward.
“That’s the million dollar question because we can’t rush this. We have to get a bank of blood from concussed players and participants to give us the strength in our convictions in terms of what we are saying and that will take time.
“The CARE Consortium though have a much broader range of case studies and the hope is that we will get there a whole lot quicker than without.”
For further information about the CARE Consortium check out: www.careconsortium.net
For further information about the collaboration between Leinster Rugby and Trinity College Dublin click HERE.
Left to Right: Dr. Jim O’Donovan (Team Doctor), Garreth Farrell (Head Physiotherapist), Karl Denvir (Senior Physiotherapist), Dr. Steve Broglio (CARE Consortium), Dr. Fiona Wilson (Trinity College Dublin), Brendan O’Connell (Sub-Academy Physiotherapist) and Fearghal Kerin (Rehabilitation Physiotherapist).