Rugby's temporary substitution for head injury assessment adopted into law

World Rugby has adopted temporary substitution for head injuries at the elite level into Law 3.10, further underscoring the governing body’s commitment to evidence-based research driving player welfare enhancements for players at all levels of the sport.

World Rugby's number-one priority is player welfare and any clear signs or symptoms of concussion or suspected concussion - at all levels of the game - must result in the immediate and permanent removal of players from the playing or training environment as highlighted within the organisation's #RecogniseAndRemove education campaign.

At the elite level of the game, a global trial has enabled temporary substitution for a head injury assessment (HIA) when it is unclear if the player has a suspected concussion. Following overwhelmingly positive results, this trial will officially become law, effective from 1 August, 2015.

The temporary substitution time period has proven successful in assisting medical staff to assess and make an informed decision regarding the removal of players when suspected concussion is not clear. The entire process includes strict side-line assessment based on the best available evidence and rigid follow-up procedures.

This HIA tool combines cognitive, balance and memory tests and is derived from the SCAT 3 recommended by the experts from the Zurich Concussion Consensus Group to assist medics in making the correct decision following a head impact. World Rugby is the first sport to use access to an on-field law to obtain post-injury management compliance resulting in improved diagnostic accuracy of concussion and improved player safety.

World Rugby Chief Medical Officer Dr Martin Raftery said: "World Rugby's number-one priority is player welfare and allowing temporary substitution for head injury has proven to be a massive step forward in protecting our elite players following a head injury.

"As someone who has been involved as a team doctor in elite sport for more than 25 years, I firmly believe that medical management of concussion in rugby has never been stronger. Law changes, pitch-side and post-injury management, combined with greater education and awareness are ensuring that we continue to put our players first."

Research has underpinned the HIA process throughout. Prior to the temporary substitution, 56 per cent of players with a confirmed concussion remained on the field following their injury. Now that figure is less than 12 per cent (British Journal of Sports Medicine, 2014).

Raftery added: "World Rugby is committed to the best-possible standards of care for our players and the research suggests that increased rates of reported concussion are largely due to the changing culture around recognition and diagnosis. Our mission is to reduce that 12 per cent further with concussion education, prevention and research, and our message to the global rugby community is clear – recognise and remove."

World Rugby’s commitment to progressing concussion education, prevention, education and research is reflected in the adoption of mandatory education for players, coaches, referees and medics, an untoward incident system review and innovative player welfare standards for Rugby World Cup and all World Rugby events.

For more information, contact:

Dominic Rumbles

Head of Communications, World Rugby

T: +353-86-8520-826

E: dominic.rumbles@worldrugby.org

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