| Abstract ID |
| 20260075 |
| Category |
| Sports Medicine: Epidemiology and Injury Prevention |
| Preferable Presentation |
| Both |
| Title |
| ON-SITE ASSESSMENT OF SPORTS RELATED CEREBRAL CONCUSSION IN RUGBY: IMPLEMENTATION AND EFFICACY OF WORLD RUGBY HIA PROTOCOL |
| Author |
|
| Presenter |
| wang zheng |
| Abstract |
| On-site Assessment of Sports Related Cerebral Concussion in Rugby: Implementation and Efficacy of World Rugby HIA Protocol Background Sports related cerebral concussion (SRCC) is a common traumatic brain injury occurred in rugby. It may lead to serious long-term sequelae such as post-concussion syndrome, life-threatening second-impact syndrome (with a mortality rate of approximately 50%), and chronic traumatic encephalopathy. For standardizing accurate identification and systematic management of SPCC, World Rugby developed a standardized Head Injury Assessment (HIA) Protocol, which had been officially applied to Asia Rugby events in 2025. Objective This study aimed to explore systematically the implementation framework and clinical application value of the World Rugby HIA Protocol on the on-site assessment of SRCC in rugby, verify the protocol’s adaptability and effectiveness in Asian rugby events, and thereby provide evidence-based reference for the standardized management of SRCC in Asian athletic events. Study Design Descriptive-Analytical Study & Technical Report Methods & Results HIA protocol applied a multi-stage and multi-model assessment design, including 5 core steps: HIA 0 (pre-competition baseline monitoring), collecting data on the athletes’ basic cognition, balance function, and health baseline information for establishing individual comparison standards; HIA 1 (immediate on-site assessment), on-field screening rapidly conducted within 12 minutes after head impact events, covering key indicators such as consciousness status, orientation ability, balance function, and core symptom questionnaire; HIA 2 (early post-injury assessment), completed within 3 hours after the injury, early concussion can be identified, through standardized cognitive test, memory evaluation and clinical symptom re-assessment; HIA 3 (delayed follow-up assessment), carried out 36-48 hours after the injury, aiming to conduct supplementary assessments for delayed symptoms and potential function impairments; HIA 4 (return-to-activity permission assessment), determine whether the athlete is qualified to return to the field safely based on the results of multi-stage evaluations. Data were derived from the protocol application in the 2025 Asian Rugby Series, focusing on key assessment indicators, operational procedures, and supporting systems. In this tournament, HIA 1 effectively identified critical positive signs, including disorientation, balance disturbance, confusion, and suspected loss of consciousness; all positive cases were promptly excluded from immediate return to play. HIA 2 and HIA 3 further facilitated the detection of early and delayed concussions through standardized tests, which clinical symptoms and signs emerged in as the most predictive sub-components, while immediate memory and tandem gait tests provided limited additional diagnostic value. Additionally, the medical team ensured seamless inter-professional coordination during the tournament. The protocol achieved a 100% compliance rate with operational procedures, with an average assessment initiation time of 3.2 minutes following head impact. Notably, no cases of second-impact syndrome or missed concussion diagnoses were reported throughout the competition period. Conclusion World Rugby HIA Protocol provides a systematic, evidence-based framework for the on-site assessment of SRCC in rugby. Its multi-dimensional, and staged evaluation system significantly enhances the accuracy of on-site diagnosis of SRCC, safeguards athlete health and safety, and holds significant value for widespread promotion and application in Asian sports medicine practice. Keywords: Sports related cerebral concussion, On-site Assessment, HIA Protocol, Asia arena |