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Despite being an obvious risks in collision sports like rugby league and AFL, concussion is almost impossible to objectively diagnose.
Key points:
- Doctors say a concussion test that cannot be cheated by athletes keen to get back on the field is needed
- A objective new eye test is being researched that could provide the answer
- The test measures minute changes in the eye in response to light
According to doctors, current tests are susceptible to influence from patients who do not want to be diagnosed — like footballers, who want to get back on the field after a head injury.
The fear is that some are using flaws in the testing methods to avoid diagnosis while suffering concussions in order to return to the field.
But new research could provide the "holy grail" doctors and sport scientists have searched for — a simple, objective test for concussion that cannot be cheated.
An eye-test has been developed that may be able to detect symptoms of concussion, simply by measuring the pupil's response to light.
If proven to work, it has the potential to dramatically change the way concussion is tested for on the sidelines, putting people at risk out of harm's way.
Patient feedback means flaws in testing
Medical professionals complain that current tests rely too heavily on feedback from the patient.
Common sideline assessments include asking patients how they feel, memory tests and balance tests — including standing on one leg, and walking in a straight line.
They have been compared to old-fashioned sobriety tests for drunk drivers.
Chief medical officer at the AIS, David Hughes, said it was far from ideal.
"Potentially, the outcome can be determined by how that patient's feeling, or whether that patient really wants to be diagnosed with concussion or not," Dr Hughes said.
"There are stories about sometimes athletes deliberately fudging baseline tests, so that when they do get a concussion, it doesn't look so bad.
"The holy grail really is to find an objective test."
While the attitude of players to concussions is improving rapidly, former NRL player Alan Tongue said some would always be reluctant to leave the field.
Tongue, who played more than 200 games for the Canberra Raiders, said many wanted to shake it off.
"When I was playing, and I know in the eras before me as well, it was that attitude of you don't want to let your teammates down," he said.
But Tongue said concussions were not a matter players should have any say in.
"We've really got to take that decision out of the players hands, and put their welfare first and foremost," he said.
A simple but 'space age' solution
Over 10 years researchers at the Australian National University (ANU) have worked on a device that can measure minute changes in the response of pupils to light.
A person's visual system is particularly vulnerable to the impacts of concussion, connected to around half the brain's circuitry.
The test can be completed in a matter of minutes, delivering immediate results.
Rachel Jaros from the John Curtin School of Medical Research at ANU is leading a new study into the potentials of the technology.
"It's a little bit space age ... it looks like something out of a sci-fi movie," she said.
"They will look into a screen, and on that screen will be a series of light stimulus.
"They won't necessarily be aware of those light stimulus, and we have two cameras measuring their pupil response."
Based on those results, doctors can then determine if a patient has suffered a brain injury like concussion.
The machine is confined to a desk, but it is hoped it can eventually be made smaller and more portable.
Footballers to be put to the test
Researchers are looking to expand the study, but finding people who have recently suffered a concussion is proving tricky.
Ms Jaros said they were going straight to the most common source — those playing heavy-impact sport, in the hope they can be tested if injured.
"We'll be recruiting male participants, between the ages of 18 and 28, who engage in regular collision sporting activities," she said.
"So AFL, rugby union, rugby league."
Those who suffer concussions during the season will be tested shortly after the injury and again when they are cleared to return to play.
Other technology will form part of the research, including a device developed by the University of Canberra, testing how the brain controls movement in the lower limbs.
It is thought a deterioration in a person's ability to move their lower limbs, even at the most subtle levels, can signal brain injury.
Topics: sport, sports-injuries, australian-national-university-0200, university-of-canberra-2617, canberra-2600, act, australia
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