Acute and subacute clinical markers after sport-related concussion in rugby union players.

OBJECTIVES: The purpose of this study was to investigate the relationship between on-field post-concussion symptoms reported by athletes, on-field neurological signs reported by a trainer or physician, and/or post-concussion symptoms 72 h after brain injury in male rugby players. DESIGN: Cross-sectional study in a Sports Concussion Clinic setting. METHODS: We enrolled 92 adult rugby union players, within the first 72 h after sport concussion. Four scales were measured. Immediate Concussion Sign Checklist (sideline); Immediate Concussion Symptom Checklist (24 h after concussion); Post-Concussion Symptoms Scale and Beck Depression Inventory (in-office 72 h after concussion). RESULTS: Odds ratios revealed that overtly symptomatic athletes were over 2.6 times more likely (p = 0.047) to exhibit post-traumatic amnesia than asymptomatic athletes. There were no differences in terms of on-field loss of consciousness or confusion. Immediate symptoms reported by athletes retrospectively were associated with symptoms reported on the Beck Depression Inventory (odds ratio 2.8; 95 % confidence interval 1.14-6.88), headache (odds ratio 4.9; 95 % confidence interval 1.92-12.79), memory concerns (odds ratio 3.15; 95 % confidence interval 1.06-9.34), pressure in the head (odds ratio 2.8; 95 % confidence interval 1.03-8.08), and visual disturbances (odds ratio 3.9; 95 % confidence interval 1.05-14.50) reported 72 h after sports concussion. CONCLUSIONS: Athletes who were overtly symptomatic after sports concussion were significantly more likely to experience post-traumatic amnesia and two or more on-field concussion signs relative to those athletes who were asymptomatic. Also, players with immediate symptoms reported higher depressive symptoms, somatic symptoms (headache and visual disturbances), and cognitive symptoms.

Lesiones medulares catastróficas en el rugby argentino. Impacto de las medidas implementadas y su reducción relativa en el tiempo / Catastrophic spinal cord injuries in argentine rugby. Impact of the measures implemented and their relative reduction in time

Introducción: Se entiende por lesión catastrófica a cualquier trauma grave que comprometa la cabeza, el cerebro, la columna vertebral o la médula espinal, que pone en riesgo la vida o puede dejar una discapacidad permanente o semipermanente. En la Argentina, la incidencia de lesionados en el ámbito del rugby es alta comparada con la de otros países. En los últimos años, se han implementado múltiples medidas de prevención y se han modificado normas con el objetivo de evitar las lesiones catastróficas. materiales y métodos: Se analizaron datos obtenidos de una encuesta telefónica realizada en el marco de colaboración entre la Unión Argentina de Rugby y la Fundación para la Lucha de Enfermedades Neurológicas de la Infancia (Fleni). Se realizó un análisis descriptivo de los datos. Se recopilaron los cambios en las normativas del deporte, que pudieran tener impacto en las futuras lesiones. Resultados: Se observa que el número de lesiones se mantiene estable año tras año. Al asociar este dato con un aumento sostenido de la cantidad de jugadores por año, impresiona haber una disminución relativa del riesgo de lesionarse. Conclusiones: Las lesiones catastróficas generan un gran impacto en la calidad de vida del jugador y de su entorno. Deben considerarse inadmisibles y se deben incrementar los esfuerzos para lograr eliminar los riesgos de lesionarse. El esfuerzo de las entidades reguladoras impresiona tener un impacto positivo al haberse logrado una reducción relativa de las lesiones en relación con el aumento de jugadores año tras año. Nivel de Evidencia: IV

Introduction: A catastrophic injury is defined as any serious trauma that involves the head, brain, spine, or spinal cord. They are life-threatening or may leave a permanent or semi-permanent disability. In Argentina, there is a high incidence of injuries. materials and methods: Data obtained from a t elephone survey carried out in the collaborative framework between the Union Argentina de Rugby and the Fundación para la Lucha de Enfermedades Neurológicas de la Infancia (Fleni, by its acronym) were analyzed. We carried out a qualitative analysis of the data and their relationship to progressive changes in sports regulations. Results: It was observed that the number of injuries remained stable year after year. When associating this fact with a sustained increase in the number of players per year, we can see a relative decrease in the risk of injury. Conclusion: Catastrophic injuries have a gr eat impact on the quality of life of the player and his environment. They must be considered inadmissible and the efforts must be increased to achieve zero risk. In recent years, multiple preventive measures have been implemented and regulations have been modified in order to avoid catastrophic injuries. Level of Evidence: IV

Cross-cultural adaptation and validation of the Argentinean version of the Roland-Morris Disability Questionnaire.

STUDY DESIGN: Psychometric testing of a translated, culturally adapted questionnaire. OBJECTIVE: Argentinean Roland-Morris Disability Questionnaire (RMDQ) validation and cross-cultural adaptation for its use in Argentinean population with lumbar pain. SUMMARY OF BACKGROUND DATA: The RMDQ is one of the most widely used and validated instruments for measuring disability in low back pain. However, no validated Argentine version of the Test was available at the time our study was initiated. MATERIALS AND METHODS: The RMDQ Argentinean cross-cultural adaptation was tested among 132 chronic lumbar pain patients, of which, 50 completed the pre-final RMDQ questionnaire and did a retest 24 hours later. The data gathered, as well as the absent response rate and the conflictive sentences for the patient were reviewed. There were no sentences marked as conflictive, therefore, the RMDQ (final) was handed out to another 82 patients. The interclass correlation coefficient was used to assess reliability and internal consistency by means of the Cronbach's alpha. The convergent validity was assessed calculating Pearson's correlation coefficient comparing the RMDQ's results with: the amount of pain (EVA), the range of movement of the spine, and the tightening of the hamstrings by means of the Active Knee Extension Test (through digital inclinometry). RESULTS: Reliability Test-retest (24 hours): interclass correlation coefficient: 0.940 (P < 0.01). Internal consistency reached 0.904 Cronbach's alpha. The RMDQ's convergent validity calculating Pearson's correlation coefficient was r: 0.544 (P < 0.01) for EVA and r: -0.378 (P < 0.01) for range of movement from T1, which is in agreement with previous results published in similar studies. Concurrent validity was assessed correlating the RMDQ results with the Argentinean Oswestry Disability Index calculating Pearson's Coefficient and it proved very good, r: 0.811 (P < 0.01). CONCLUSION: The results of the study show that the Argentinean version of the RMDQ is reliable and valid as a lumbar disability measurement tool. The authors recommend this tool for future clinical studies.