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Selective head-and-neck cooling as a treatment method for concussions in elite male rugby union players : The Clinical Observed Outcomes with Local HEad-and-neck cooling After Diagnosed concussions (COOLHEAD) study protocol

Brown, James ; Dunlop, Michael ; Badenhorst, Marelise ; Owen, Cameron ; Marklund, Niklas LU orcid ; Andrews, Peter ; Hay, Andrew ; Bazo, Marco ; Rossouw, Herman and Hanly, David , et al. (2025) In BMJ Open Sport and Exercise Medicine 11(4).
Abstract

Sports-related concussions (SRCs) typically occur when the brain is hyperthermic. Acute head-and-neck cooling should, therefore, reduce the brain's metabolic demands, with the potential to improve recovery following an SRC. Elite ice hockey players who underwent head-and-neck cooling after sustaining a concussion (SRC) showed reduced return-to-play times, although further investigation is warranted. This paper aims to describe the methods proposed for investigating the clinical effects and feasibility of acute head-and-neck cooling in elite male rugby union players. A quasi-experimental study will be conducted in two professional male rugby competitions (clusters): the United Rugby Championship 'intervention group' and the PREM Rugby... (More)

Sports-related concussions (SRCs) typically occur when the brain is hyperthermic. Acute head-and-neck cooling should, therefore, reduce the brain's metabolic demands, with the potential to improve recovery following an SRC. Elite ice hockey players who underwent head-and-neck cooling after sustaining a concussion (SRC) showed reduced return-to-play times, although further investigation is warranted. This paper aims to describe the methods proposed for investigating the clinical effects and feasibility of acute head-and-neck cooling in elite male rugby union players. A quasi-experimental study will be conducted in two professional male rugby competitions (clusters): the United Rugby Championship 'intervention group' and the PREM Rugby 'standard care group'. Both groups will follow World Rugby's standardised, graduated return-to-play concussion management protocols. In addition to this, within 30 min of the SRC, the intervention group will be offered head-and-neck cooling for 45 min. The quantitative phase of the study will collect return-to-play times and clinical outcomes in both groups (sample size calculated: 100 concussions per cohort). The qualitative phase will explore the experiences of players and medical teams with the intervention. Intention-to-treat and per-protocol analyses, using appropriate regression modelling techniques, will adjust for possible confounders between the two groups, and thematic content analysis will be employed in the analysis of the respective phases. The Clinical Observed Outcomes with Local HEad-neck cooling After Diagnosed concussions study will provide evidence regarding acute head-and-neck cooling as a potential adjunct treatment to current concussion management in elite male rugby union.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ Open Sport and Exercise Medicine
volume
11
issue
4
article number
e002915
publisher
BMJ Publishing Group
external identifiers
  • pmid:41070207
  • scopus:105018108874
ISSN
2055-7647
DOI
10.1136/bmjsem-2025-002915
language
English
LU publication?
yes
id
8c652111-4b6d-4a57-aa58-b87a99f7e8c1
date added to LUP
2025-11-25 09:18:33
date last changed
2025-12-09 10:38:59
@article{8c652111-4b6d-4a57-aa58-b87a99f7e8c1,
  abstract     = {{<p>Sports-related concussions (SRCs) typically occur when the brain is hyperthermic. Acute head-and-neck cooling should, therefore, reduce the brain's metabolic demands, with the potential to improve recovery following an SRC. Elite ice hockey players who underwent head-and-neck cooling after sustaining a concussion (SRC) showed reduced return-to-play times, although further investigation is warranted. This paper aims to describe the methods proposed for investigating the clinical effects and feasibility of acute head-and-neck cooling in elite male rugby union players. A quasi-experimental study will be conducted in two professional male rugby competitions (clusters): the United Rugby Championship 'intervention group' and the PREM Rugby 'standard care group'. Both groups will follow World Rugby's standardised, graduated return-to-play concussion management protocols. In addition to this, within 30 min of the SRC, the intervention group will be offered head-and-neck cooling for 45 min. The quantitative phase of the study will collect return-to-play times and clinical outcomes in both groups (sample size calculated: 100 concussions per cohort). The qualitative phase will explore the experiences of players and medical teams with the intervention. Intention-to-treat and per-protocol analyses, using appropriate regression modelling techniques, will adjust for possible confounders between the two groups, and thematic content analysis will be employed in the analysis of the respective phases. The Clinical Observed Outcomes with Local HEad-neck cooling After Diagnosed concussions study will provide evidence regarding acute head-and-neck cooling as a potential adjunct treatment to current concussion management in elite male rugby union.</p>}},
  author       = {{Brown, James and Dunlop, Michael and Badenhorst, Marelise and Owen, Cameron and Marklund, Niklas and Andrews, Peter and Hay, Andrew and Bazo, Marco and Rossouw, Herman and Hanly, David and Dyson, Craig and Jones, Daniel and Stokes, Keith and Kemp, Simon P.T. and Cross, Matt and Jones, Ben}},
  issn         = {{2055-7647}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open Sport and Exercise Medicine}},
  title        = {{Selective head-and-neck cooling as a treatment method for concussions in elite male rugby union players : The Clinical Observed Outcomes with Local HEad-and-neck cooling After Diagnosed concussions (COOLHEAD) study protocol}},
  url          = {{http://dx.doi.org/10.1136/bmjsem-2025-002915}},
  doi          = {{10.1136/bmjsem-2025-002915}},
  volume       = {{11}},
  year         = {{2025}},
}