Protecting the Integrity & Reputation of Irish Horseracing

Medical

Concussion Assessment / Guidelines / Protocols

CONCUSSION ASSESSMENT PROTOCOL

Baseline Concussion Testing

All jockeys / riders will have baseline testing every two years.

Flat jockeys working abroad for the Winter/Spring will be required to have completed testing within 2 weeks of their return.

This will take place at one of 3 regional centres. These centres will be located in private (independent) clinics or G.P. surgeries and trained nurses at each location will carry out the NP testing on behalf of the I.H.R.B. Each jockey/rider will be required to

  • complete a computerised Neuro-psychological (NP) test (Cogstate) - http://cogstate.com
  • a series of pen and paper tests (SCOLP, Digit Span, SDMT:Symbol Digit Modalities Test, Colour Trails, STROOP)
  • GAD7 and PHQ9 Questionnaires

– the whole process will take about 60 minutes to complete.

The various tests will then be evaluated by one of a team of Clinical Neuro-psychologists retained by the I.H.R.B.

Standard Assessment of Concussion

(post event, on-course) - Concussion Assessment Tool –SCAT 5.

Whenever a jockey/rider suffers a fall, the doctor in attendance at the racecourse/ point to point will carry out a standardised medical assessment.

This will involve a set of screening questions and a tandem balance test.

A more detailed neurological evaluation using SCAT 5 will be used where concussion is suspected. The jockey / rider considered to be concussed will be stood down from race riding while the evaluation is being carried out.

In every case, the doctor will be required to make a definitive diagnosis in regard to concussion – YES / NO. If a diagnosis of concussion is made the jockey/rider will be stood down for a minimum of 6 days.

Post-concussion evaluation

(fitness to return to race riding)

Any jockey/rider who is diagnosed as having suffered concussion will be required to undergo a detailed evaluation before being allowed to return to race riding:

Within 72 hours referral to Santry Sports Centre or an equivalent centre for:

•    Full clinical evaluation including SCAT 5
•    GAD7 and PHQ9 Questionnaires
•    Exercise Test (Buffalo protocol)
•    Balance test on force plates
•    Individualised presentation-specific rehabilitation i.e. vestibule-ocular etc.

Day 6
1.    Cogstate
2.    
•    Full clinical evaluation including SCAT 5
•    GAD7 and PHQ9 Questionnaires
•    Exercise Test (Buffalo protocol)
•    Balance test on force plates

The reports from both of these examinations will be sent to the I.H.R.B Senior Medical Officer who will then be responsible for deciding if the jockey/rider can safely be allowed to return to race riding, or if a further period of rehabilitation is required.

If the NP tests are judged by the neuropsychologist to be abnormal i.e. a failure to return to baseline levels, or if the jockey /rider fails the Sports Physician / Sports Physiotherapist assessments, he / she will be stood down for a further 14 days and the rehabilitation programme continued, after which repeat post-concussion evaluation as on Day 6 will take place.

If the jockey / rider has not recovered fully by Day 20 they will be referred to the I.H.R.B Neurologist for assessment.  

For a concussed rider who is hospitalized following the initial fall they will undergo the “Day 6” assessment as soon as they are fit to do so.

All jockeys / riders will be subjected to the same concussion assessment at the time of injury and to the same post-concussion evaluation to determine when they are ready to return to race riding.


Dr. Adrian Mc Goldrick,
Senior Medical Officer,
Irish Horseracing Regulatory Board,
The Curragh,
Co. Kildare.
00353-872424404
adrianmcgoldrick4@gmail.com

Concussion Centres
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Safety Details - Helmets & Body Protector
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