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Sports PhysiotherapyFeb 7, 2024

UK-based researchers shine a light on long-lasting impact of sports-related traumatic brain injuries

Almost half of people who suffer a sports-related traumatic brain injury still experience physical symptoms after six months, according to a research article published last month (January) in JAMA Network Open.

The study was led by the University of Stirling in collaboration with the University of Glasgow. The article’s senior author was Lindsay Wilson from the University of Stirling’s Division of Psychology.

Professor Wilson said: ‘It is usually thought that people with sport-related TBI [traumatic brain injury] will have good outcomes, particularly if they have an injury that is classified as mild, but these patients have never been compared to those with non-sport-related TBI on a range of different outcomes.’

Professor Wilson and his co-authors found that some sports – such as horse riding (22 per cent of all sport-related cases studied), skiing (17 per cent), and football (13 per cent) – were more often associated with TBI.

The researchers, who included William (Willie) Stewart, consultant neuropathologist and honorary professor at the University of Glasgow, analysed data for 4,360 patients from 18 European countries who attended hospital with TBI and had a brain scan.

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The researchers found that sports such as skiing were more often associated with TBI

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Injuries are not 'mild'

Professor Stewart said: ‘This work demonstrates that for up to a third of people attending hospital with so called mild traumatic brain injuries from sport, the injury is anything but “mild” with persisting symptoms reported at six months.”

The study compared 256 people with sports-related concussions (5.9 per cent of the cohort studied) to 4,104 people who sustained a concussion another way. Patients were assessed when attending hospital immediately after their injury, then followed up at three months and six months. The team used standard scales that show when someone has incomplete recovery, persistent disability, and persistent post-concussion symptoms.

After six months there was incomplete recovery in 46 per cent of all patients with sport-related brain injury, 39 per cent in those with mild sport-related brain injury, and 31 per cent of individuals with mild sport-related brain injury and a normal brain scan.

There have been many previous studies examining concussion in sport, but little is known about individuals who present at hospital with TBI incurred during sport-related activities.

Co-author Michail Ntikas, a PhD researcher, said: ‘We found that people with brain injury in sports who attend hospital still have persisting problems six months later.

‘Even those with a mild traumatic brain injury and a normal brain scan, sometimes also called concussion, still have problems affecting daily life six months later, showing that recovery is poorer than expected.’

The data were collected as part of a European Commission-funded study called CENTER-TBI and analysis was assisted by staff from the University of Cambridge and the University Hospital of Antwerp in Belgium.

The findings have implications for injury prevention and management and indicate that even among individuals with sports injuries considered to be mild, many would benefit from systematic follow-up [Michail Ntikas et al]


The authors conclude: ‘In this cohort study, the sample with SR-TBI [sport-related TBI] differed from the NSR-TBI group and was characterized by having lower risk factors for poor outcome. Six months after SR-TBI, recovery of mental health and postconcussion symptoms were better than in the NSR-TBI group, even after considering risk factors in the group.

‘However, in contrast to the idea that recovery after mild TBI or concussion is unproblematic, we found that approximately one-third of individuals with SR-TBI with GCS [Glasgow Coma Scale] scores of 13 to 15 and negative CT [computed tomography] results had persisting disability at 6 months.’

They add: ‘The findings have implications for injury prevention and management and indicate that even among individuals with sports injuries considered to be mild, many would benefit from systematic follow-up.’

To read the full version of the study – titled Contrasting Characteristics and Outcomes of Sports-Related and Non–Sports-Related Traumatic Brain Injury – click 

 This article is based on a release issued by the University of Glasgow on 29 January.

Author: I A McMillan
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