Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players

Abstract Background Using functional near-infrared spectroscopy (fNIRS) as an objective diagnostic tool, we aimed to (1) compare fNIRS measurements in adult and youth male rugby players against controls over a playing season, and 2) document the fNIRS changes that occur in concussed rugby players du...

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Main Authors: Ben Jones, Mohammadreza Jamalifard, Sally Waterworth, Mike Rogerson, Javier Andreu-Perez, Jay Perrett, Edward Hope, Jason Moran, Tom Adams, Jyotpal Singh, Patrick Neary, Chris E. Cooper
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Sports Medicine - Open
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Online Access:https://doi.org/10.1186/s40798-025-00849-2
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author Ben Jones
Mohammadreza Jamalifard
Sally Waterworth
Mike Rogerson
Javier Andreu-Perez
Jay Perrett
Edward Hope
Jason Moran
Tom Adams
Jyotpal Singh
Patrick Neary
Chris E. Cooper
author_facet Ben Jones
Mohammadreza Jamalifard
Sally Waterworth
Mike Rogerson
Javier Andreu-Perez
Jay Perrett
Edward Hope
Jason Moran
Tom Adams
Jyotpal Singh
Patrick Neary
Chris E. Cooper
author_sort Ben Jones
collection DOAJ
description Abstract Background Using functional near-infrared spectroscopy (fNIRS) as an objective diagnostic tool, we aimed to (1) compare fNIRS measurements in adult and youth male rugby players against controls over a playing season, and 2) document the fNIRS changes that occur in concussed rugby players during the England Rugby Football Union Graduated Return-To-Play programme (GRTP). Sixty-seven participants (rugby = 41 (26 adults: 27.5 ± 4.4 years; 15 youth: 16.5 ± 0.6 years; control = 26 (11 adult: 30.5 ± 5.2 years; 15 youth: 16.9 ± 0.4 years) completed fNIRS assessments at pre, mid and end-season. Eight players (five youth, three adult) sustained concussions, and completed fNIRS and the Graded Symptom Checklist from the Sport Concussion Assessment Tool version 5 (SCAT5) assessment throughout the GRTP period. Mixed linear models were utilised to assess the effect of group and time on fNIRS measures of oxyhaemoglobin (∆O2Hb) and deoxyhaemoglobin (∆HHb) during performance tasks. Typical Error (TE) i.e., normal biological fluctuation and measurement error, was calculated to identify ‘cut-off’ thresholds for identifying effects of concussion. Results There were significant differences in fNIRS indices over time in adult and youth groups (p < 0.05) but no significant differences between rugby and control groups (p > 0.05). Seven out of eight (87.5%) concussed players showed changes greater than TE during the GRTP period for both ∆O2Hb and ∆HHb during performance tasks and these players’ ∆O2Hb profiles had not returned to within ‘normal’ levels within the GRTP period. All players’ symptom severity and number returned to normal within the GRTP period. Conclusion Current GRTP protocols alone are problematic and there is a need for a more individualised approach to concussion management, utilising objective biomarker tools such as fNIRS.
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spelling doaj-art-2b898024843448669c409cfbfb3e128a2025-08-20T03:53:57ZengSpringerOpenSports Medicine - Open2198-97612025-05-0111111210.1186/s40798-025-00849-2Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union PlayersBen Jones0Mohammadreza Jamalifard1Sally Waterworth2Mike Rogerson3Javier Andreu-Perez4Jay Perrett5Edward Hope6Jason Moran7Tom Adams8Jyotpal Singh9Patrick Neary10Chris E. Cooper11School of Sport Rehabilitation and Exercise Sciences, University of EssexSchool of Computer Science and Electronic Engineering, University of EssexSchool of Sport Rehabilitation and Exercise Sciences, University of EssexSchool of Sport Rehabilitation and Exercise Sciences, University of EssexSchool of Computer Science and Electronic Engineering, University of EssexPhysiGo, Carlton Business CentreSchool of Sport and Exercise Sciences, Liverpool John Moores UniversitySchool of Sport Rehabilitation and Exercise Sciences, University of EssexSchool of Sport Rehabilitation and Exercise Sciences, University of EssexFaculty of Kinesiology & Health Studies, University of ReginaFaculty of Kinesiology & Health Studies, University of ReginaSchool of Sport Rehabilitation and Exercise Sciences, University of EssexAbstract Background Using functional near-infrared spectroscopy (fNIRS) as an objective diagnostic tool, we aimed to (1) compare fNIRS measurements in adult and youth male rugby players against controls over a playing season, and 2) document the fNIRS changes that occur in concussed rugby players during the England Rugby Football Union Graduated Return-To-Play programme (GRTP). Sixty-seven participants (rugby = 41 (26 adults: 27.5 ± 4.4 years; 15 youth: 16.5 ± 0.6 years; control = 26 (11 adult: 30.5 ± 5.2 years; 15 youth: 16.9 ± 0.4 years) completed fNIRS assessments at pre, mid and end-season. Eight players (five youth, three adult) sustained concussions, and completed fNIRS and the Graded Symptom Checklist from the Sport Concussion Assessment Tool version 5 (SCAT5) assessment throughout the GRTP period. Mixed linear models were utilised to assess the effect of group and time on fNIRS measures of oxyhaemoglobin (∆O2Hb) and deoxyhaemoglobin (∆HHb) during performance tasks. Typical Error (TE) i.e., normal biological fluctuation and measurement error, was calculated to identify ‘cut-off’ thresholds for identifying effects of concussion. Results There were significant differences in fNIRS indices over time in adult and youth groups (p < 0.05) but no significant differences between rugby and control groups (p > 0.05). Seven out of eight (87.5%) concussed players showed changes greater than TE during the GRTP period for both ∆O2Hb and ∆HHb during performance tasks and these players’ ∆O2Hb profiles had not returned to within ‘normal’ levels within the GRTP period. All players’ symptom severity and number returned to normal within the GRTP period. Conclusion Current GRTP protocols alone are problematic and there is a need for a more individualised approach to concussion management, utilising objective biomarker tools such as fNIRS.https://doi.org/10.1186/s40798-025-00849-2Functional Near-Infrared SpectroscopyConcussionRugbyGraduated Return To Play
spellingShingle Ben Jones
Mohammadreza Jamalifard
Sally Waterworth
Mike Rogerson
Javier Andreu-Perez
Jay Perrett
Edward Hope
Jason Moran
Tom Adams
Jyotpal Singh
Patrick Neary
Chris E. Cooper
Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
Sports Medicine - Open
Functional Near-Infrared Spectroscopy
Concussion
Rugby
Graduated Return To Play
title Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
title_full Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
title_fullStr Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
title_full_unstemmed Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
title_short Cerebral Haemodynamic Assessment Following Sport-related Concussion (Mild Traumatic Brain Injury) in Youth and Amateur Rugby Union Players
title_sort cerebral haemodynamic assessment following sport related concussion mild traumatic brain injury in youth and amateur rugby union players
topic Functional Near-Infrared Spectroscopy
Concussion
Rugby
Graduated Return To Play
url https://doi.org/10.1186/s40798-025-00849-2
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