Press releases 12th July 2017

Education, regulation and research central to new concussion management initiatives

  • Series of enhancements to concussion management in British racing announced, in conjunction with PJA, IJF and RCA
  • Education projects include poster campaign involving Richard Johnson, Lizzie Kelly and Martin Dwyer, in association with Headway – the brain injury association
  • Latest internationally-recognised concussion assessment (SCAT) methodology to be adopted on racecourses, and changes made to process for jockey baseline neurological testing
  • Sophisticated research project to analyse how jockeys fall under way at University College Dublin, in conjunction with the BHA and BETA

The British Horseracing Authority (BHA), in conjunction with the Racecourse Association (RCA), Injured Jockeys Fund (IJF) and Professional Jockeys Association (PJA), has today announced a series of initiatives to further tackle the challenge of concussion management in British racing. The initiatives revolve around education, regulation and research and are intended to endure that British racing remains at the forefront of concussion management in sport.

Dr Jerry Hill, Chief Medical Adviser for the BHA, said: “Concussion management is one of the major issues facing world sport at present. While British racing has for some time been a pioneer on this topic, I am determined that we remain at the forefront of scientific research, education and regulation when it comes to this crucial issue. Racing is a high-risk sport for concussion and, quite simply, our approach to assessment, management and treatment must be no less than world class.

“Education is essential to managing concussion. No matter how effective our medical teams can become in assessing and treating head injuries, we need our participants to be aware of the serious consequences that concussion can have and, in particular, the risks around continuing to compete when suffering from concussion. Whatever our role in racing we have a collective responsibility to ensure anyone who may be concussed is identified and protected during their recovery.”

Education

Central to the initiatives are two education campaigns aimed at raising awareness of the effects of concussion, the potential impacts of continuing to compete with a concussion injury, and how to recognise and manage head injuries. In the first of these, the BHA has teamed up with the Headway – the brain injury association and top jockeys Richard Johnson, Lizzie Kelly and Martin Dwyer to produce a poster campaign which raises awareness of concussion and links into the Headway #ConcussionAware programme.

In addition, the BHA, RCA, IJF and PJA have developed a pocket-sized head injury advice leaflet called ‘H.E.A.D S.T.A.R.T to recovery’. This leaflet outlines how to manage a safe return to race riding after concussive headinjury with the contact details of support organisations. 1,000 of these leaflets will be available to be distributed to racecourses and other relevant centres including Oaksey House, Jack Berry house and licensed yards as well as being sent out by the PJA to their members.

Lisa Hancock, Chief Executive of the IJF, said: “Obviously the more jockeys that are aware of the short and long term effects of concussion, the better. Our teams at Jack Berry House and Oaksey House are always available to support all jockeys with any concerns they may have and a general awareness of the symptoms is key. ”

Peter McCabe, Chief Executive of Headway – the brain injury association, said: “We are delighted to be able to work with the horse racing authorities as part of our Concussion Aware campaign. It is vital that jockeys have a greater understanding and awareness of concussion, including how to identify it and the appropriate action to take. In the majority of cases, there will no long-term damage caused by a concussion – if treated appropriately with rest and medical assessment. Occasionally, complications can arise from seemingly minor blows to the head, which is why it is vital that people seek medical attention following a concussion. Our advice is clear, if in doubt, sit it out.”

Regulation

Alongside the education projects, the BHA is in consultation with the IJF and PJA regarding two significant alterations to the way in which concussion and brain injuries are managed. Firstly, the BHA has proposed to upgrade its trackside sport concussion assessment tool (SCAT) for evaluating concussion to the newly published SCAT5. This means that all jockeys who are treated for a potential head injury will be assessed using the latest and most up-to-date methodology, as published by the Concussion in Sport Group.

Secondly, the BHA has altered its baseline ‘Cogsport’ neuro-psycholoical screening methodology, in order to be more convenient for jockeys but also ensure that it is as robust as possible. Under the old system riders baseline screening was carried out every year using a digital-only method. Under the new policy the screening will be carried out every two years, but using the more rigorous digital & pen and paper method. All of these initiatives follow significant enhancements to the BHA’s concussion management protocols in 2016 across the full concussion management process, from baseline cognitive testing, trackside diagnosis and care through to post-injury follow-up, assessment and treatment and return-to-riding clearance.

Paul Struthers, Chief Executive of the Professional Jockeys Association, said: “Racing is fortunate that it has taken concussion seriously for longer than other sports and it is important that the screening for concussion is based on the latest advice, and whilst the changes to the baseline testing will make the test a little longer it will save jockeys both time and expense when compared to the annual test. We also fully support the educational efforts, which will be complemented by the release later this year of a film focusing on concussion as part of the #JockeyMatters series produced by the Jockeys Education & Training Scheme (JETS) in partnership with the PJA. The more people that understand the importance of screening for and managing concussion properly, the better.” 

Research

The BHA – in conjunction with the British Equestrian Trade Association (BETA) – recently updated and enhanced its ‘Helmet Bounty Scheme‘, which sees jockeys who are concussed during a race provided with a retail voucher that can be redeemed towards the cost of replacing their damaged hat. The BHA and BETA are today pleased to announce that helmets which are returned to BETA via this scheme are now being sent to University College Dublin alongside a video of the fall, alongside similar events in other equine disciplines. The helmets and footage will then be used as part of a significant research project to develop a sophisticated computer modelling of how a jockey falls and how their bodies, in particular their heads, are impacted by these falls. The hope is that this will provide data to assist in future safety developments.

Michael Gilchrist, Professor of Mechanical Information for University College Dublin said: “University College Dublin and its partners in the European HEADS consortium have been working with the Turf Club, BETA and British Eventing to reconstruct equestrian accidents in order to help inform the development of new safety standards and next generation helmets.  We are delighted to be collaborating with BHA to extend the set of accident cases which will inform our research and look forward to providing new scientific insights into the effects that rotational accelerations and translational accelerations have on the occurrence of traumatic brain injury.  This will help to inform the development of next generation equestrian helmets.”

Claire Williams, Executive Director of BETA, said: “We have been involved in this project for more than a year and can already see the value in having information from damaged helmets and rider injury detail available. This helps to improve our understanding of falls and head injuries and, in the long term, we hope that the gathered data can be used  in the design of riding hats and the standards used to test them, and this in turn will lead to the improvement of safety for all involved.”

Notes to editors:

1. The basics of concussion management in British Racing are as follows. Please note, this is not an exhaustive summary of the process but simply covers the basic and immediate elements of trackside treatment and return-to-riding:

Following a fall all Jockeys have to be assessed on the racecourse using the newly published SCAT5 methodology and if there is any suspicion of concussion undergo a sport-specific screening test of symptom score, short and long term memory and balance. If the diagnosis is not clear at that point a longer assessment can be undertaken with further questions and tests of neurological function including balance, memory and mental processing.

Those with a positive test for concussion will be stood down from riding and either be sent to hospital, particularly if any other injuries are present, or allowed home accompanied by a responsible adult with specific follow up instructions in writing. They are advised not to drive.

If symptoms are then recognised later, after the initial assessment, jockeys will undergo further assessment. In certain cases those riders who are involved in a heavy fall but pass an initial test can undergo a further assessment approximately 25 to 30 minutes after the first test – even if they are not displaying obvious symptoms – in case of late onset concussion.

All jockeys are required to undergo baseline neuro-psychological screening every two years at one of six regional centres prior to the granting of a licence. Following a concussive incident, a rider is immediately stood down for a minimum of six days. Following this stand down period a specialist reassesses the rider and a comparison is made of his/her repeat neuro-psychological tests against the baseline values. Only when these have returned to normal is the jockey allowed to return to race riding. During this process jockeys will be invited to take part in an active rehabilitation programme to aid their return to riding.

2. Headway – the UK’s leading brain injury charity – provides support, services and information to brain injury survivors, their families and carers, as well as to professionals in the health and legal fields. It has more than 100 groups and branches throughout the UK. More information can be found at https://www.headway.org.uk/.

• This media release was originally published by the British Horseracing Authority (BHA) on 12 July 2017. To access the original, please click here.

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