Concussion



  • I know this is topical at present, but based on nothing other than my own impressions, is that we seem to have a shitload more guys missing games this year than before?

    Have the protocols improved, is it awareness? Are other nations on the same page, again, just my impression, but we seem to have more missing out due to concussion than others.

    RS spoke to Blues doctor, Steven Kara this afternoon and he talked them through the concussion protocols, was interesting.

    ABout 7 mins or so into the first one and then into the 2nd clip as well

    http://120.138.20.16/WeekOnDemand/radiosport/2017.05.24-17.00.00-S.mp3
    http://120.138.20.16/WeekOnDemand/radiosport/2017.05.24-17.15.00-S.mp3



  • @taniwharugby Interesting to hear the actual steps involved in the HIA in all three phases.

    It obviously helps prevent the players gaming the issue as has often been suggested.



  • First post & its got footnotes, ha. Hi you lot

    Im wondering if any of the medical staff with our Kiwi SR teams are trying out near-infrared LED devices to alleviate concussion symptoms? Id have Dane Coles on one yesterday. 20~30mins twice a day. http://vielight.com/product/vielight-neuro-alpha/ US$1,750. (I have no affiliation; couple of blogs offer discounts).

    Because there are what look like some remarkable recent studies, on the effects of near-infrared light on brain conditions 1. 2. (2. used an earlier version of that device).

    So bigger studies are underway (eg US NFL 3., US Vets Admin 4.) The key is understanding that near-infrared light affects the brain at the level of basic cellular metabolic activity 5., so it has broad application to a wide variety of brain conditions: Alzheimers, Parkinsons, TBI traumatic brain injury - and probably including concussion (aka mild TBI) 5. 6.

    Studies now give a much better idea of the wavelengths and power to use. (Some earlier studies on stroke were unimpressive, it seems the light wasnt effectively getting to the brain). 810nm is the best wavelength to penetrate the skull.

    Its inexpensive, considered non-toxic, its a new and still not very well-known field. Photobiomodulation. For the players sake, and the national interest! 🙂 please pass this on to the team Docs, Physios, Managers, Steve Tew, whoever could help get it trialled. If its not being already?

    here's the heavy lifting. Look at this shit >
    (TBI is Traumatic Brain Injury, NILT near infrared light therapy, PBM photobiomodulation, AD Alzheimers)

    1. ...The case series of ten patients included civilians with TBI from motor vehicle accidents and veterans with TBI from impact and from blast injuries. Over 90% of the patients had complaints of irritability, insomnia, anxiety, and depression. Six of the ten patients had persistent headaches and 50% had cognitive difficulties, attention problems, and other signs of executive dysfunction. After a course of ten treatments of NILT (20 treatments in four patients), each patient experienced significant clinical improvement. Many of their symptoms resolved. Sixty percent had no residual symptoms after treatment. The remainder had mild or greatly reduced symptoms. Cognitive function appeared to improve since all disabled or impaired patients had returned to work, although cognitive tests were not performed. The quality of life dramatically improved in all cases....
      Multi-watt near-infrared light therapy as a neuroregenerative treatment for traumatic brain injury. Theodore A. Henderson, M.D., Ph.D. Neural Regen Res. 2016 Apr; 11(4): 563–565. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870908/

    2. When did ya ever see a dementia study with good results?
      Significant Improvement in Cognition in Mild to Moderately Severe Dementia Cases Treated with Transcranial Plus Intranasal Photobiomodulation: Case Series Report.
      https://www.ncbi.nlm.nih.gov/pubmed/28186867
      Photomed Laser Surg. 2017 Feb 10. doi: 10.1089/pho.2016.4227.
      There was significant improvement after 12 weeks of PBM (MMSE, p < 0.003; ADAS-cog, p < 0.023).
      ...This is the first completed PBM case series to report significant, cognitive improvement in mild to moderately severe dementia and possible AD cases.
      CONCLUSIONS: Results suggest that larger, controlled studies are warranted. PBM shows potential for home treatment of patients with dementia and AD.

    3. LED Therapy for the Treatment of Concussive Brain Injury. ongoing study as at August 2016.
      https://clinicaltrials.gov/ct2/show/NCT02383472
      A double blind randomized trial of light-emitting diode (LED) therapy for patients suffering from mild traumatic brain injury (mTBI). Patients seen in the Sports Concussion Clinic ....
      Detailed Description: Concussion, also known as mild traumatic brain injury (mTBI), results from a rotational acceleration of the brain. The biomechanical forces which cause concussion lead to the opening of ion channels within the neuronal cell membranes, allowing for a massive influx of sodium and efflux of potassium. This results in a spreading depression type of phenomenon, leading to the depolarization of neurons diffusely throughout the brain.19 In order to restore the homeostatic ion gradients across the membrane, the sodium-potassium pumps require increasing amounts of adenosine triphosphate (ATP). Thus, there is an increased need for ATP after concussion. ATP is supplied by the glycolysis of glucose from the blood stream. Both experimental models of concussion and human studies, however, show decreased cerebral blood flow after the initial response to injury. Thus, there is an increased demand for ATP after concussion; but a diminished supply of glucose to meet the demand.
      The absorption of light in the red/near infrared wavelength spectrum by cytochrome C oxidase increases ATP synthesis. Thus, by increasing ATP synthesis, red/near infrared LEDs can treat the underlying pathophysiological cause of concussion symptoms. If successful, this would be the first therapy to directly treat the underlying pathophysiology of concussion.

    4. "We are applying a technology that's been around for a while," says lead investigator Dr. Margaret Naeser, "but it's always been used on the body, for wound healing and to treat muscle aches and pains, and joint problems. We're starting to use it on the brain." https://www.research.va.gov/currents/spring2015/spring2015-7.cfm

    5. Shining light on the head: Photobiomodulation for brain disorders. Oct 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066074/
      Michael R. Hamblin Wellman Center for Photomedicine, Massachusetts General Hospital; Department of Dermatology, Harvard Medical School; Harvard-MIT Division of Health Sciences and Technology, Cambridge.
      ...The brain suffers from many different disorders that can be classified into three broad groupings: traumatic events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer's and Parkinson's), and psychiatric disorders (depression, anxiety, post traumatic stress disorder). There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head...
      btw Dr. Michael R. Hamblin of Harvard is a major photobiomodulation lead researcher.

    6. Turning On Lights to Stop Neurodegeneration: The Potential of Near Infrared Light Therapy in Alzheimer’s and Parkinson’s Disease. Frontiers in Neuroscience 1 January 2016 https://www.ncbi.nlm.nih.gov/pubmed/26793049
      ...This mechanism is presumably common to all the above mentioned conditions and is perhaps why NIr therapy has such broad potential applications...

    Inexpensive, apparently non-toxic - & major potential benefit.
    Please please pass this on to all the right people.



  • Thought I'd bump up this thread because I've found this video with Dr Stephen Kara with one of the 1014 boys pretty interesting:

    By the way, there's been some interesting theories going around that the spate of failed All Black concussions are a result of us tackling lower to avoid yellow cards (and as a result getting hit with hips and legs). Not sure if that's been discussed on here before?



  • @Milk cheers,

    Read the book League of Denial (https://en.wikipedia.org/wiki/League_of_Denial) recently. Good read, similar to the film Concussion (it was the source fo the film), but without the dramatisation. Interesting, and scary.

    Rugby doesn't seem to have the same issue, as the number of head hits is a lot lower. The scrimmage line in NFL gets beaten at training, and then dozens of times in the game. Rugby doesn't have helmets, so doesn't have a culture of using the head as a weapon.

    Very sobering though, and it seems a matter of time until there are deep rooted changes in american football.