Concussion Incidence and Recurrence in Professional Australian Football Match-Play: A 14-Year Analysis.
ABSTRACT: Concussion incidence rates in professional Australian football may be underreported due to the injury classification definition. A myriad of factors contribute to concussion risk; however, there is limited long-term surveillance in Australian football. This study analysed concussion in one Australian football team over an extended period.Match-play concussion injuries in one team (n = 116 participants) were diagnosed and treated by the team physician over 14 years. Analysis of factors related to concussion including matches played, time of day and season, and return to play provided an insight into occurrence and recurrence rates.140 concussions were recorded (17.6 per 1000 player match hours). A strong relationship was evident between matches played and concussion incidence (r = 0.70) and match conditions did not negatively affect the concussion rate. Whether an athlete returned to play in the same match or suffered a loss-of-consciousness concussion (p = 0.84), their ensuing rate of concussion was not affected.Concussion in professional Australian football was related to the number of matches played. Further, neither previous incidence nor loss of consciousness affected future concussion risk. This study provides ecologically valid evidence of the concussion incidence rate in professional Australian football and has implications for the management of athletes sustaining concussion injuries.
Project description:Collision sports, such as Rugby Union (“Rugby”) have a particularly high risk of injury. Of all injuries common to collision sports, concussions have received the most attention due to the potentially negative cognitive effects in the short- and long-term. Despite non-professional Rugby players comprising the majority of the world’s playing population, there is relatively little research in this population. Stellenbosch Rugby Football Club (“Maties”), the official rugby club of Stellenbosch University, represents one of the world’s largest non-professional Rugby clubs, making this an ideal cohort for community-level injury surveillance. The aim of this study was to describe the incidence and events associated with concussion in this cohort. Baseline demographics were obtained on the 807 male student Rugby non-professional players who registered for the 10-week long 2018 season, which comprised 101 matches and 2,915 of exposure hours. All match-related injuries were captured by the medical staff of Stellenbosch Campus Health Service on an electronic form developed from the consensus statement for injury recording in Rugby. The mean age, height and weight of this cohort were 20 ± 2 years, 182 ± 7 cm and 88 ± 14 kg, respectively. Overall, there were 89 time-loss injuries, which equated to an injury rate of 30.6 per 1,000 match hours [95% confidence intervals (CIs): 24.2–36.9], or about one injury per match. The most common injury diagnosis was “concussion” (n = 27 out of 90 injuries, 30%), at a rate of 9.3 per 1,000 match hours (95% CIs: 5.8–12.8). The three most common mechanisms of concussion in the present study were performing a tackle (33%), accidental collision (30%) and being tackled (11%). Concussion was the most common injury in this population, at a rate that was six times higher than the most comparable study from the UK, which had far more exposure time over six seasons and wider range of player ability, from recreational to semi-professional. This might be explained by the training and vigilance of the club’s first aiders observing all matches for concussion. Future studies should try to explain this high rate and subsequently reduce these concussions. The addition of video surveillance data would assist in identifying the etiology of these concussions injuries in order to develop specific targeted interventions.
Project description:Australian Rules football comprises physical and skilled performance for more than 90 min of play. The cognitive and physiological fatigue experienced by participants during a match may reduce performance. Consequently, the length of time an athlete is on the field before being interchanged (known as a stint), is a key tactic which could maximize the skill and physical output of the Australian Rules athlete. This study developed two methods to quantify the relationship between athlete time on field, skilled and physical output. Professional male athletes (n = 39) from a single elite Australian Rules football club participated, with physical output quantified via player tracking systems across 22 competitive matches. Skilled output was calculated as the sum of involvements performed by each athlete, collected from a commercial statistics company. A random intercept and slope model was built to identify how a team and individuals respond to physical outputs and stint lengths. Stint duration (mins), high intensity running (speeds >14.4 km · hr-1) per minute, meterage per minute and very high intensity running (speeds >25 km·hr-1) per minute had some relationship with skilled involvements. However, none of these relationships were strong, and the direction of influence for each player was varied. Three conditional inference trees were computed to identify the extent to which combinations of physical parameters altered the anticipated skilled output of players. Meterage per minute, player, round number and duration were all related to player involvement. All methods had an average error of 10 to 11 involvements, per player per match. Therefore, other factors aside from physical parameters extracted from wearable technologies may be needed to explain skilled output within Australian Rules football matches.
Project description:Previous studies have analysed the influence of contextual variables on performance and physical demands in soccer. However, the points needed to remain in the category have been an element that has not been analysed previously. The aim of the present study was to investigate the influence of match location, match period, strength of the opponent and the points required to keep category on physical performance in professional soccer players. Fourteen Spanish second B Division League matches played by a professional football team were analysed during the 2016/17 season using GPS devices. The 10 main players of each match used the GPS throughout the match. The variables of Total Distance (m), High Intensity Distance (m), High intensity Accelerations (n), Sprint Time (s) and Sprint Distance (m) were analysed. The most notable differences are found in Total Distance covered. Away games accumulated significantly more distance than those played at home, but only in the second half (+230.65 m, IC95%: 21.94 to 438.19, ES: 0.46, p = 0.031). There are no differences depending on the strength of the opponent. However, players covered greater distances during the first half in those matches that were played furthest from salvation (+235.86 m, 95% CI: 49.03 to 422.70, ES: 0.51, p = 0.014). Total Distance is the main parameter affected by situational variables. In addition, the pressure of being further away from saving the category increases the distance covered by players in a game.
Project description:OBJECTIVE:The objective is to determine if suspected concussions in elite football are medically assessed according to the International Conferences on Concussion in Sport consensus statement recommendations. SETTING:Men's Union of European Football Association (UEFA) Football Championship. PARTICIPANTS:All professional football players in the UEFA 2016 Championship Tournament. DESIGN:Observational study. OUTCOME MEASURES:Potential concussive events (PCEs) were defined as direct head collision incidents resulting in the athlete being unable to immediately resume play following impact. PCEs identified and description of PCE assessment and outcome were accomplished through direct standardised observation of video footage by trained observers in 51 games played in the Men's UEFA European Championship (10 June-10 July 2016). RESULTS:Sixty-nine total PCEs (1.35 per match) were identified in 51 games played during the 2016 Men's UEFA European Championship. Forty-eight PCEs (69.6%) resulted in two observable signs of concussion, 13 (18.8%) resulted in three signs and 1 (1.4%) resulted in four signs in the injured athletes. Nineteen (27.5%) PCEs were medically assessed by sideline healthcare personnel while 50 (72.5%) were not. Of the 50 PCEs that were not medically assessed, 44 (88%) PCEs resulted in two or more signs of concussion among injured athletes. Of the 19 medically assessed PCEs, 8 resulted in 3 signs of concussion, and 1 resulted in 4 signs; all assessments concluded in the same-game return for the injured athletes. CONCLUSIONS:PCEs were frequent events in the 2016 UEFA Euro championship, but were rarely assessed concordant with the International Conferences on Concussion in Sport consensus statement recommendations. There is an imperative need to improve the assessment and management of players suspected of concussion in elite football.
Project description:OBJECTIVE:Identify patterns in the nature and characteristics of potential concussive events (PCEs) in football. METHODS:This study analysed the incidence and characteristics of PCEs that occurred during the 2014 and 2018 Fédération Internationale de Football Association World Cups, and the 2016 UEFA Euro Cup. PCEs were defined as direct head collision incidents resulting in the athlete being unable to immediately resume play for at least 5 sec following impact. RESULTS:A total of 218 incidents were identified in 179 matches (1.22 per match, 36.91 per 1000 hours of exposure). The most common mechanism of PCE was elbow-to-head (28.7%, n=68). The frontal region was the most frequently affected location of impact with 22.8% (n=54). CONCLUSION:Our study defined the identification, prevalence and nature of PCEs in professional international soccer tournaments. Our findings indicate the different contexts and mechanisms of head contact and contact to different regions of the head can be associated with varying signs of concussion. The results highlight targets for future injury prevention strategies.
Project description:This study aimed to develop a model to objectively benchmark professional Australian Rules football (AF) player performance based on age, experience, positional role and both draft type and round in the Australian Football League (AFL). The secondary aims were to identify the stage of peak performance and specific breakpoints in AF player performance longitudinally. AFL Player Ratings data were obtained for all players (n = 1052) from the 1034 matches played during the 2013-2017 seasons, along with data pertaining to the abovementioned player characteristics. Two separate linear mixed models revealed that all factors influenced player performance, with age and experience the strongest in each model, respectively. Post hoc Tukey tests indicated that performance was affected by age at each level up until the age of 21 (effect ranging from 0.98 to 3.70 rating points), and by experience at the levels 1-20 and 21-40 matches in comparison to all higher levels of experience (effect ranging from 1.01 to 3.77 rating points). Two segmented models indicated that a point of marginal gains exists within longitudinal performance progression between the age levels 22 and 23, and the experience levels 41-60 and 61-80 matches. Professional sporting organisations may apply the methods provided here to support decisions regarding player recruitment and development.
Project description:Concussion is a prevalent brain injury in sport and the wider community. Despite this, little research has been conducted investigating the dynamics of impacts to the unprotected human head and injury causation in vivo, in particular the roles of linear and angular head acceleration.Professional contact football in Australia.Adult male professional Australian rules football players participating in 30 games randomly selected from 103 games. Cases selected based on an observable head impact, no observable symptoms (eg, loss-of-consciousness and convulsions), no on-field medical management and no injury recorded at the time.A data set for no-injury head impact cases comprising head impact locations and head impact dynamic parameters estimated through rigid body simulations using the MAthematical DYnamic MOdels (MADYMO) human facet model. This data set was compared to previously reported concussion case data.Qualitative analysis showed that the head was more vulnerable to lateral impacts. Logistic regression analyses of head acceleration and velocity components revealed that angular acceleration of the head in the coronal plane had the strongest association with concussion; tentative tolerance levels of 1747?rad/s(2) and 2296?rad/s(2) were reported for a 50% and 75% likelihood of concussion, respectively. The mean maximum resultant angular accelerations for the concussion and no-injury cases were 7951?rad/s(2) (SD 3562?rad/s(2)) and 4300?rad/s(2) (SD 3657?rad/s(2)), respectively. Linear acceleration is currently used in the assessment of helmets and padded headgear. The 50% and 75% likelihood of concussion values for resultant linear head acceleration in this study were 65.1 and 88.5?g, respectively.As hypothesised by Holbourn over 70?years ago, angular acceleration plays an important role in the pathomechanics of concussion, which has major ramifications in terms of helmet design and other efforts to prevent and manage concussion.
Project description:The team tactical system and distribution of the football players on the pitch is considered fundamental in team performance. The present study used time-motion analysis and triaxial-accelerometers to obtain new insights about the impact of different tactical systems (1-4-5-1 and 1-3-5-2) on physical performance, across different playing positions, in a professional football team. Player performance data in fifteen official home matches was collected for analysis. The sample included twenty-two players from five playing positions (centre backs: n = 4; full-back/wide midfielder/ wing-back: n = 9; centre midfielder: n = 6 and centre forward: n = 3), making a total of 108 match observations. A novel finding was that general match physical demands do not differ considerably between these tactical formations, probably because match-to-match variability (variation of players' running profile from match-to-match) might be higher than the differences in physical performance between tactical systems. However, change of formation had a different impact across playing positions, with centre backs playing in 1-4-5-1 performing significant more HIRcounts than in 1-3-5-2 (p = 0.031). Furthermore, a medium effect size (r = 0.33) was observed in HIRdist, with wide players covering higher distances when playing in 1-3-5-2 than in 1-4-5-1. These findings may help coaches to develop individualised training programs to meet the demands of each playing position according to the tactical system adopted.
Project description:Player evaluation plays a fundamental role in the decision-making processes of professional sporting organisations. In the Australian Football League, both subjective and objective evaluations of player match performance are commonplace. This study aimed to identify the extent to which performance indicators can explain subjective ratings of player performance. A secondary aim was to compare subjective and objective ratings of player performance. Inside Football Player Ratings (IFPR) and Australian Football League Player Ratings were collected as subjective and objective evaluations of player performance, respectively, for each player during all 1026 matches throughout the 2013-2017 Australian Football League seasons. Nine common player performance indicators, player role classification, player age and match outcomes were also collected. Standardised linear mixed model and recursive partitioning and regression tree models were undertaken across the whole dataset, as well as separately for each of the seven player roles. The mixed model analysis produced a model associating the performance indicators with IFPR at a root mean square error of 0.98. Random effects accounting for differences between seasons and players ranged by 0.09 and 1.73 IFPR each across the five seasons and 1052 players, respectively. The recursive partitioning and regression tree model explained IFPR exactly in 35.8% of instances, and to within 1.0 IFPR point in 81.0% of instances. When analysed separately by player role, exact explanation varied from 25.2% to 41.7%, and within 1.0 IFPR point from 70.3% to 88.6%. Overall, kicks and handballs were most associated with the IFPR. This study highlights that a select few features account for a majority of the variance when explaining subjective ratings of player performance, and that these vary by player role. Australian Football League organisations should utilise both subjective and objective assessments of performance to gain a better understanding of the differences associated with subjective performance assessment.
Project description:<h4>Context</h4>The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]).<h4>Objective</h4>To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play.<h4>Study design</h4>A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries.<h4>Results</h4>The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play.<h4>Clinical relevance</h4>An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game.