@article{ref1,
title="Evaluation of World Rugby's concussion management process: results from Rugby World Cup 2015",
journal="British journal of sports medicine",
year="2016",
author="Fuller, Colin W. and Fuller, Gordon W. and Kemp, Simon P. T. and Raftery, Martin",
volume="51",
number="1",
pages="64-69",
abstract="OBJECTIVE: To evaluate World Rugby's concussion management process during Rugby World Cup (RWC) 2015. <br><br>DESIGN: A prospective, whole population study. POPULATION: 639 international rugby players representing 20 countries. <br><br>METHOD: The concussion management process consisted of 3 time-based, multifaceted stages: an initial on-pitch and/or pitch-side assessment of the injury, a follow-up assessment within 3 hours and an assessment at 36-48 hours. The initial on-pitch assessment targeted obvious signs of concussion, which, if identified, lead to a 'permanent removal from play' decision and a diagnosis of concussion. If the on-pitch diagnosis was unclear, a 10-min off-pitch assessment was undertaken for signs and symptoms of concussion leading to a 'suspected concussion with permanent removal from play' or a 'no indication of concussion with return to play' decision. Evaluations at 3 and 36-48 hours postmatch lead to diagnoses of 'confirmed concussion' or 'no concussion'. Medical staff's decision-making was supported during each stage by real-time video review of events. Players diagnosed with confirmed concussion followed a 5-stage graduated-return-to-play protocol before being allowed to return to training and/or competition. <br><br>RESULTS: Players were evaluated for concussion on 49 occasions, of which 24 resulted in diagnoses of concussion. Fourteen players showing on-pitch signs of concussion were permanently removed from play: 4 of the 5 players removed from play following off-pitch medical room evaluation were later diagnosed with a confirmed concussion. Five players not exhibiting in-match signs or symptoms of concussion were later diagnosed with concussion. The overall incidence of concussion during RWC 2015 was 12.5 concussions/1000 player-match-hours. <br><br>CONCLUSIONS: This study supports the implementation of a multimodal, multitime-based concussion evaluation process to ensure that immediate and late developing concussions are captured.<br><br>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/<p /> <p>Language: en</p>",
language="en",
issn="0306-3674",
doi="10.1136/bjsports-2016-096461",
url="http://dx.doi.org/10.1136/bjsports-2016-096461"
}