Argentina, the leading rugby power in Latin America, is carrying out pioneering studies for the region on long-term brain injuries affecting players with a view to heading off possible consequences in the form of cognitive deterioration.
The investigation, headed by the neurologists Fernando Salvat and Julieta Russo, began last February in the Instituto Fleni and will run for 12 years with strategic intervals.
"The information we are requesting will help us to reach conclusions enabling preventive decisions to be taken so that sports can continue to be played with increased safety," explained Salvat, who played First Division rugby for Alumni, one of Argentina’s most traditional clubs.
Some 140 former rugby players aged between 35 and 75 are participating in the investigation, which contemplates a neuro-cognitive evaluation every two years with an MRI (Magnetic Resonance Image) scan and a blood sample to detect biomarkers indicating cerebral injuries every four years.
Furthermore, the families should annually complete a questionnaire to register possible alterations in the motor and cerebral functioning of the volunteer.
Salvat and Russo had been contacted in 2015 by the UAR (Unión Argentina de Rugby) rugby association to follow and make independent evaluations of the phenomenon of cerebral concussion, a request advanced by World Rugby (previously the International Rugby Board).
From that experience emerged the motivation to undertake a more ambitious study establishing patterns of the long-term evolution of those practising this sport.
The study contemplates patients who have played in different positions although until now there is no evidence of any position in particular creating greater risk, unlike in football.
"In football it’s clear that the header is the situation most predisposed to cerebral concussion and for that there is plenty of scientific evidence of defenders over time having greater cognitive impact than those who head more sporadically," indicated Russo.
These neurologists are also trying to bury with their investigation what they consider to be erroneous ideas such as, for example, that cerebral commotion implies the momentary loss of consciousness.
"Hardly 10 percent lose consciousness due to cerebral concussion, that’s why it’s important that all those close to the players during matches pay attention to the signals that all is not well in order to take them immediately off the pitch," pointed out Salvat.
Russo added that precisely because of the difficulties in detecting them, "it has been demonstrated that less concussion is reported than actually occurs and that is why the main factor predicting cognitive deterioration is the duration of the sporting career and not the amount of concussion reported."
Salvat and Russo know that while awaiting the results of the study, there is much to be done in terms of prevention.
"It’s fundamental, for example, to improve the techniques for tackling, where 95 percent of the risks of cerebral concussion during a match arise. It should be inculcated from the youth divisions onward that this should be done squarely with both shoulders," said Salvat.
In this sense the specialist highlighted the importance of World Rugby deciding to intensify the penalties for high tackles during matches.
"At first there was no penalty, then it passed to a yellow card and now it could even be red. That collaborates with the attempts to make the sport a bit safer," he considered.
Both neurologists agree on the need for everybody involved in sport to participate in prevention and view with satisfaction that increasingly more sportspeople are adhering to this initiative.
"Today we can spread knowhow on this issue with the player as a collaborator in this project, not a passive participant. That is also a learning process which we share with them," underlined Russo.
A report published last week in the United Kingdom maintains that a co-ordinated international initiative could result in being vital for boosting the understanding of the link between cerebral concussion in sport and Alzheimer’s.
The study of the Alzheimer Research Trust and Health Policy Partnership was carried out after former rugby players, among them Ryan Jones and Steve Thompson, had denounced World Rugby and the English and Welsh federations for failing to protect them from chronic neurological injuries.
by Federico Kotlar, AFP