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AFL Chief Medical Officer Dr Michael Makdissi
The AFL has released new concussion guidelines as it faces increasing scrutiny of its handling of head injuries, with two class actions against the league expected to be lodged this week.
The updated rules require all AFL and AFLW players who have sustained a concussion to satisfactorily navigate a 11-step ‘return-to-play’ program over a minimum 12 days before they can be medically cleared to return to full contact training, followed by a return to the field [link here].
The 11-step program consists of three stages involving rest, recovery, and then a graded return to training and playing, with each step requiring a minimum 24-hour period to be completed.
If any symptoms recur, the player must return to the previous step, and players can only enter the final stage once they’ve completed testing that demonstrates clinical recovery.
The guidelines have also adopted a more conservative approach under certain circumstances.
These cases include young players, where there is a history of learning disorders or mood disturbance, or a history of multiple concussions – particularly those with prolonged recovery or previous concussion in the same season – and where there is a high symptom burden.
Neurological testing
Among other rules in the AFL Guidelines for the management of sport-related concussion (SRC), all new players must undergo screening to determine the number of previous concussions sustained and their history of prolonged recovery from concussion.
Every player is also recommended to have annual preseason baseline testing that may include neurological assessment, SCAT5 and a screening cognitive test.
The new guidance also suggests that players have a more extensive baseline assessment, including tests of domains commonly affected by concussion e.g., cervical spine, vestibular, oculomotor, etc, formal neuropsychological testing and/or structural MRI.
The AFL has also released a strategic plan on how it will evolve its concussion management and research activities over the next five years, which includes promoting a culture of education and prevention within the league and supporting affected players for life.