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A video review of multiple concussion signs in National Rugby League match play

Overview of attention for article published in Sports Medicine - Open, January 2018
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Title
A video review of multiple concussion signs in National Rugby League match play
Published in
Sports Medicine - Open, January 2018
DOI 10.1186/s40798-017-0117-9
Pubmed ID
Authors

Andrew J. Gardner, David R. Howell, Grant L. Iverson

Abstract

Video review has been introduced in many professional sports worldwide to help recognize concussions. However, to date, there has been very little research on the accuracy of using video analysis to identify signs of concussion and the various combinations of observed signs. The objective of the study is to determine the accuracy of combinations of clinical signs of concussion identified using video analysis to identify concussions in the National Rugby League (NRL). Incidences of players using of the concussion interchange rule (CIR) (n = 156), including those where athletes were diagnosed with a concussion (n = 60), were used to calculate sensitivity and specificity of various combinations of concussion signs (unresponsiveness, slow to get up, clutching/shaking head, gait ataxia, vacant stare, and apparent seizure) and their independent association with an eventual diagnosis of concussion. Using video analysis, players who were diagnosed with a concussion showed a significantly greater total number of signs at the time of injury (mean = 3.4, SD = 1.3) than those who were removed from play but not diagnosed with a concussion (mean = 3.0, SD = 0.9 signs; p = .046). Players who did not return to play during the same game demonstrated a significantly greater number of total signs than those who did return to play in the same game following CIR activation (mean = 3.4, SD = 1.2 versus mean = 2.9, SD = 0.9; p = 0.002). The most common combination of signs that was observed was clutching/shaking the head and slowness in getting up (17.3%). The sensitivity of the total number of signs observed decreased as the number of signs increased (range = 0.13-0.62), while the specificity increased as more signs were observed (range = 0.29-0.90). Most of the combinations of different observed signs at the time of potential injury were highly specific (> 0.80), but not sensitive to an eventual diagnosis of concussion. When considering all potential predictor variables in a logistic regression model, anticipating the oncoming collision (OR = 3.92, 95% CI = 1.28-12.03), fewer number of defenders involved in the tackle (OR = 0.58, 95% CI = 0.36-0.92), and the presence of a blank or vacant stare (OR = 2.97, 95% CI = 1.26-7.01) were each significantly associated with concussion diagnoses. The use of video review in the NRL is challenging, but being aware of the combinations of possible concussion signs and the likelihood that various presentations result in a concussion diagnosis can provide a useful addition to sideline concussion identification and removal from play decisions.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 83 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 15 18%
Student > Ph. D. Student 9 11%
Student > Master 8 10%
Student > Doctoral Student 4 5%
Researcher 3 4%
Other 11 13%
Unknown 33 40%
Readers by discipline Count As %
Medicine and Dentistry 16 19%
Sports and Recreations 8 10%
Nursing and Health Professions 7 8%
Psychology 5 6%
Engineering 5 6%
Other 8 10%
Unknown 34 41%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 January 2018.
All research outputs
#13,859,548
of 22,655,397 outputs
Outputs from Sports Medicine - Open
#396
of 463 outputs
Outputs of similar age
#231,329
of 441,166 outputs
Outputs of similar age from Sports Medicine - Open
#12
of 13 outputs
Altmetric has tracked 22,655,397 research outputs across all sources so far. This one is in the 37th percentile – i.e., 37% of other outputs scored the same or lower than it.
So far Altmetric has tracked 463 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 24.5. This one is in the 13th percentile – i.e., 13% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 441,166 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.