Tucker Ross, Brown James, Falvey Eanna, Fuller Gordon, Raftery Martin
World Rugby, World Rugby House 8-10 Lower Pembroke Street, Dublin 2, Ireland.
Department of Orthopaedics, Institute of Sport and Exercise Medicine, Stellenbosch University, Tygerberg, 7500, South Africa.
Sports Med Open. 2020 Aug 15;6(1):37. doi: 10.1186/s40798-020-00265-8.
Rugby Union requires annual baseline testing using the Sports Concussion Assessment Tool (SCAT5) as part of its head injury assessment protocols. Scores achieved during baseline testing are used to guide return-to-play decisions at the time of head impact events during matches, and concussion diagnosis during subsequent diagnostic screens. Baseline values must be valid, accurate representations of a player's capability in the various SCAT5 sub-modes, including symptom report, cognitive function and balance. The extent to which prior exercise may affect performance is an important consideration, and the present cross-sectional study aimed to explore how SCAT5 performance differs when assessed at rest (RSCAT) compared to after 30 min of exercise (EXSCAT) in 698 male professional rugby players for whom paired exercise and rest SCAT5 data were available.
Symptom endorsement was greater when assessed after exercise than at rest. Fatigue/Low energy was 1.5 times more likely to be reported when assessed during EXSCAT. Orientation score was improved during SCAT5s performed after exercise, but only when rest and exercise SCAT5s were conducted on the same day, suggesting a learning effect. Concentration score was impaired during EXSCAT. No other cognitive sub-modes were affected by exercise. Total errors during Modified Balance Error Scoring System (MBESS) increased during EXSCAT, as a result of increased errors made during single leg balance, irrespective of testing sequence, with 42% of players making more errors in EXSCAT, compared to 28% making more errors in RSCAT.
Symptoms, cognitive sub-modes and balance sub-modes are all affected by exercise. These may be the result of learning effects that improve cognitive performance, and the direct effects of exercise on sub-mode performance. The clinical implications of these changes may be assessed in the future through a study of diagnostic screens in players after head impact events, to confirm whether an exercise baseline screen is required annually, or whether specific sub-modes of the SCAT5 should be obtained at rest and after exercise.
英式橄榄球联盟要求每年使用运动性脑震荡评估工具（SCAT5）进行基线测试，作为其头部损伤评估方案的一部分。基线测试中获得的分数用于指导比赛中头部撞击事件发生时的重返赛场决策，以及后续诊断筛查中的脑震荡诊断。基线值必须是球员在SCAT5各个子模式下能力的有效、准确体现，包括症状报告、认知功能和平衡。先前运动可能影响测试表现的程度是一个重要考量因素，本横断面研究旨在探讨在698名有配对的运动和休息时SCAT5数据的男性职业橄榄球运动员中，与休息时评估的SCAT5（RSCAT）相比，运动30分钟后评估的SCAT5（EXSCAT）表现有何不同。
运动后评估时的症状认可程度高于休息时。在EXSCAT评估期间，疲劳/精力不足被报告的可能性是休息时的1.5倍。在运动后进行的SCAT5测试中，定向得分有所提高，但只有在同一天进行休息和运动时的SCAT5测试时才会出现这种情况，这表明存在学习效应。EXSCAT期间注意力得分受损。没有其他认知子模式受运动影响。改良平衡误差评分系统（MBESS）的总误差在EXSCAT期间增加，这是由于单腿平衡时误差增加所致，与测试顺序无关，42%的球员在EXSCAT中出现更多误差，而在RSCAT中这一比例为28%。
症状、认知子模式和平衡子模式均受运动影响。这些可能是改善认知表现的学习效应以及运动对子模式表现的直接影响的结果。未来可通过对头部撞击事件后球员诊断筛查的研究来评估这些变化的临床意义，以确定是否每年都需要进行运动基线筛查，或者是否应在休息时和运动后获取SCAT5的特定子模式。
