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Rutgers study finds that sports-related concussions are harder to diagnose than previously known

Concussion symptoms of fatigue and neck pain were reported by players regardless of whether they experienced a head injury, a Rutgers researcher says. – Photo by Robina Weermeijer / Unsplash

Rutgers researchers have found that typical symptoms of concussions may be caused by high-intensity exercise rather than actual injuries to the head, suggesting that the standardized tool commonly used to assess sports-related head injuries may often misdiagnose athletes, according to a press release.

Stephanie Iring, a coauthor of the study and a Rutgers Biomedical and Health Sciences (RBHS) doctoral candidate, said the Sport Concussion Assessment Tool (SCAT) is used to assess the symptoms of a concussion in athletes after a head injury, although it is not used as a stand-alone tool.

“In our work, we found that rugby players who had just completed a high-intensity rugby match reported many symptoms that were like those reported by players after a head injury,” Iring said.

The study was conducted by screening non-injured and injured rugby players using the SCAT after a match. It found that non-injured players reported nine concussion symptoms on average compared to injured players who reported 26 symptoms on average, according to the press release.

Concussion symptoms of fatigue and neck pain were reported by players whether or not they experienced a head injury. Players who did experience a head injury also primarily reported symptoms such as experiencing headaches and "not feeling right," she said.

“Our data shows that exertion during a match increased the number and severity of self-reported symptoms in control players even though they had not experienced a head impact,” Iring said. “This could lead to difficulty differentiating these players from those that had experienced a head impact when using on-field assessments.”

She also said that researching this matter is important for the impact that it will have on creating diagnoses for athletes in the future.

“Sports-related head impacts have been found to have long-term impacts in some athletes, even sometimes when mild,” Iring said. “Determining that an athlete has suffered a head injury is critical to early diagnosis and may lead to better treatments.”

The findings of this study were presented at the American Physiological Society after an effort from Iring to share their findings at the Experimental Biology conference, she said. Iring and Serrador are now working on the manuscript for their research to be shared further.

 “Shortly after we submitted the abstract, I got an email stating that our work had the potential to draw interest from the media, and we agreed to promote our research,” she said. “We were very pleased to have had many reach out to us to just to learn and understand the importance of our work.”

Iring said the idea to conduct the study came from her mentor, Jorge Serrador, coauthor of the study and associate professor at RBHS. Serrador played rugby at a time when the protocol only consisted of assuring that the person would wake up the next day.

She said that Serrador thought that there must be a better way to diagnose a concussion, and he then formulated the idea to conduct the study to focus on the matter, she said.

“This work highlights that while players with head impact may report more symptoms generally, we have to be cautious in using all symptoms since some are common after intense exercise even when there was no head impact,” Iring said. “Overall, it is important to consider the effects of exercise ... to assess concussions.”

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