Int J Sports Med 2017; 38(1): 71-75
DOI: 10.1055/s-0042-116072
Clinical Sciences
© Georg Thieme Verlag KG Stuttgart · New York

Usefulness of Video Review of Possible Concussions in National Youth Rugby League

A. J. Gardner
Priority Research Centre for Stroke & Brain Injury, School of Medicine & Public Health, University of Newcastle, Callaghan, Australia
R. M. N. Kohler
DR KOHLER Sports Injuries Specialist, Gold Coast, Australia
C. R. Levi
Sports Concussion Program, Hunter New England Local Health District, New Lambton Heights, Australia
G. L. Iverson
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, United States
› Author Affiliations
Further Information

Publication History

accepted after revision 12 August 2016

Publication Date:
13 October 2016 (eFirst)


A new concussion interchange rule (CIR) was introduced in 2014 for the National Rugby League and National Youth Competition (NYC). The CIR allows a player suspected of having sustained a concussion to be removed from play and assessed without an interchange being tallied against the player’s team. Participants included all NYC players who used the CIR during the 2014 season. 2 raters completed video analysis of 131 (of a total of 156 reported) uses of the CIR, describing injury characteristics, situational factors, and concussion signs. The incidence rate was 44.9 (95% CI: 38.5–52.3) uses of the CIR per 1 000 NYC player match hours, or approximately one CIR use every 1.3 games. Apparent loss of consciousness/unresponsiveness was observed in 13% of cases, clutching the head in 65%, unsteadiness of gait in 60%, and a vacant stare in 23%. Most incidences occurred from a hit-up (82%). There appeared to be some instances of video evidence of injury but the athlete was cleared to return to play in the same game. Video review appears to be a useful adjunct for identifying players suffering possible concussion. Further research is required on the usefulness of video review for identifying signs of concussive injury.