Eye-tracking technology trialled in bid to diagnose concussion

Oculomotor function believed to alter at the time of concussion or shortly afterwards

Dr Éanna Falvey, seen here treating Johnny Sexton during the 2017 Lions Tour, has welcomed the trial of eye-tracking technology in diagnosing concussion. Photograph: James Crombie/Inpho

Dr Éanna Falvey, seen here treating Johnny Sexton during the 2017 Lions Tour, has welcomed the trial of eye-tracking technology in diagnosing concussion. Photograph: James Crombie/Inpho

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The latest eye-tracking technology using virtual reality (VR) for the detection and treatment of concussion made its debut in Super Rugby Trans-Tasman 2021 last weekend.

Recent studies have suggested that oculomotor function – eye movement – alters at the time of a concussion or shortly afterwards. World Rugby, New Zealand Rugby and Rugby Australia have partnered with NeuroFlex to run an in-match trial and the technology was used across all five games in which the quintet of New Zealand teams beat their Australian counterparts over the weekend, and will continue as a trial for the remainder of the tournament.

A statement by World Rugby said: “The technology is being used alongside the current Head Injury Assessment (HIA) to objectively determine whether NeuroFlex could further enhance the HIA process, currently operating at 90 per cent accuracy in elite competitions.

“This innovative way to identify altered oculomotor function and head movement will also be used within the six-stage graduated return-to-play process to monitor players returning from injury and protect their health.

“NeuroFlex is an objective test that could further improve rugby’s approach to brain health, supporting doctors to make the right decision. Numerous scientific studies have demonstrated that oculomotor functions are altered at the time of, or shortly after a concussion and the ground-breaking trial aims to verify the test’s diagnostic accuracy.

“In the lead-up to Super Rugby Trans-Tasman, teams have been embracing the study with all participating players undertaking baseline testing under controlled conditions to provide an accurate comparison for use when a player comes off for an HIA.

NeuroFlex VR testing measures oculomotor function and is being trialled in the Super Rugby Trans-Tasman competition. Photograph: World Rugby
NeuroFlex VR testing measures oculomotor function and is being trialled in the Super Rugby Trans-Tasman competition. Photograph: World Rugby

“Data collected from the NeuroFlex VR testing will be used to compare the accuracy of concussion identification based on the eye and head movements versus the current iteration of the HIA. The trial’s outcomes will inform future moves that the sport will take in advancing the welfare of players.”

A second eye-tracking technology provider – EyeGuide – will be trialled in another competition yet to be confirmed.

The equipment can capture the necessary data in just 10 seconds, allowing multiple screenings to be conducted, and World Rugby’s chief medical officer, Dr Éanna Falvey, believes it can further reduce the chances of a concussed player returning to the pitch.

“As a key element of our progressive approach to injury reduction and management, rugby continually explores and assesses technology developments that could enhance the care of players in our sport, from community rugby to the elite competitions,” said Falvey.

“We believe that oculomotor screening examination in rugby has the potential to boost the identification and management of concussions by objectively identifying potential abnormalities in oculomotor function between a player’s baseline and when removed for an HIA assessment, adding to the depth of identification methods available to the sport.

“We are excited about this work and would like to thank New Zealand Rugby and Rugby Australia for embracing it. The ambition of this partnership with NeuroFlex is to determine the technology’s objective diagnostic accuracy in a rugby environment and help inform the advancement of World Rugby’s future concussion identification and management strategies.”

Improving technology in the campaign to reduce head injuries and make the game safer for participants of all ages is a priority for World Rugby who, along with the English Rugby Football Union and the Welsh Rugby Union, are facing a lawsuit from retired players who have been diagnosed with the signs of early-onset dementia.

This is the first trial of its kind in elite sport, and as it is an objective test it could become another means by which decisions regarding concussions and return to play are taken out of the players’ hands.

If this trial is successful, the technology could be rolled out globally.

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