Florey Department of Neuroscience and Mental Health - Theses

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    The Nature and Severity of Central Nervous System Dysfunction after Concussion in Contact Sport
    Drajkopyl, Edith ( 2019)
    Introduction. Traumatic brain injuries, including sports-related concussions, are a major public health concern. Although participation in sport brings with it many benefits, the potential risk of sustaining adverse injuries such as sports-related concussion is an escalating societal and ethical issue. The onset of short-lived impairment of central nervous system dysfunction in concussed athletes following a sport-related concussion can lead to complications if the condition is not recognised and removed from participation in sport in a timely manner. Rationale and Study aims. This series of studies aim to understand the nature and magnitude of head biomechanics, short-lived impairment of central nervous system (CNS) function, and clinical signs and symptoms associated with concussions and repetitive head impacts. More specifically, it is hypothesised that (i) the biomechanics of repetitive head impacts in amateur boxers, (ii) endorsement of symptoms, and performance on cognition and balance component scores immediately post-contest and, (iii) a decline in function on the King-Devick test, will be worse for boxers clinically classified with a concussion, be associated with high-risk for CNS injury circumstances, and be reflective of exposure to repetitive head impacts through exposure to repeat contests in the tournament. Method. Healthy male collegiate students (n = 376) between the ages of 18-34 years (M = 20.97, SD = 2.30) consented to participate in the Notre Dame Bengal Bouts amateur boxing tournament in 2012 and/or 2013. Boxers completed the Sports Concussion Assessment tool, Cogstate Brief Battery, and the King-Devick test prior to participation in any sparring and following each of the four elimination contests. A sample of boxers were also instrumented with X2 Biosystems headbands to monitor exposure to impacts during contests. Results. The results of this study support the hypothesis that in amateur boxers the number of head impacts, and the acceleration of those impacts are associated with the progress through the tournament, outcome of bouts, weight class, and concussion. However, there were no systematic differences in the number or magnitude of impacts between concussed and non-concussed boxers, although average rotational forces did show potential for the classification of concussed boxers. Symptom, cognition, and balance scores did not systematically change with multiple assessments nor with repeat exposure to head blows further into the tournament, however, symptom component scores were sensitive to and worse for boxers classified on performance factors representative of high-risk for CNS injury, such as sustaining a concussion, receiving a standing eight-count, and losing a contest. The cognitive component was successful in identifying concussed boxers from non-concussed boxers. But there were no meaningful differences on the balance component clinically relevant to the assessment of concussion-related changes. The King-Devick test was largely not sensitive to concussion in the context of amateur boxing and unable to appropriately classify most concussed boxers. Conclusion. This study offers guidance on the measures which provide the best predictive power for the classification of central nervous system dysfunction following a sport-related concussion and adds to the literature on repetitive head impacts. Though innovative, further study of the biomechanics of concussive head injury, amateur boxers, and the use of screening tools are warranted.