Concern about the lifelong impacts of concussions on teenagers led a group of researchers to develop a framework of support for schools to help pupils return to learning and exercise.
A collaboration of researchers at the School of Physiotherapy at the University of Otago – Ōtākou Whakaihu Waka and the Sports Performance Research Institute NZ at Auckland University of Technology, with initial involvement from New Zealand Rugby, co-designed a framework for concussion management in secondary schools.
Project co-lead Professor Gisela Sole, of Otago's School of Physiotherapy, says mild head injuries are of increasing concern, and youth in Aotearoa New Zealand have a particularly high incidence rate of the condition.
Professor Gisela Sole
"In 2022, teenagers made up 37 per cent of all ACC concussion claims," she says.
"While 70 per cent of people who have sustained a concussion recover within 10 to 14 days, 30 per cent develop long-term symptoms that can impact learning, emotions, and even future work employability."
Aside from the normal concussion symptoms such as headaches, neck pain, and blurred vision, pupils who have sustained a concussion often struggle to concentrate, are sleepy, irritable, behave differently to usual, and have decreased academic performance.
Recovery from concussion involves mental and physical rest and a gradual return to learning, which Professor Sole says can be at odds with the academic demands of secondary school. Early detection and a managed return to learning and physical activity is critical for timely recovery.
"Children and adolescents generally take longer to recover than adults and New Zealand Rugby research has shown players with concussion were often 'lost' at secondary school with little support provided for their return to learning.
"By developing a framework with schools to support their students in their recovery, we can hopefully mitigate the risk of long-term symptoms developing."
In the latest phase of the project, published in the New Zealand Journal of Physiotherapy, the group worked with 12 schools in Auckland, Hawkes Bay and Otago in 2022 and 2023, covering 82 pupils with concussion, the majority of which were sports related.
The framework is based on raising awareness of the signs and symptoms of concussion and the importance of early diagnosis by a healthcare provider; and identifying, monitoring and supporting students with concussion until they fully return to learning and sports.
The majority of schools (11) indicated they found the framework useful and would continue using it.
Professor Sole hopes the Ministry of Education and ACC will encourage other schools to also implement the framework to enhance concussion management across the country.
In general, she also believes there needs to be greater awareness about the risks of concussion, particularly repeated incidents, and greater encouragement to report them.
More about the FRAmework for MaNaging Concussions in New Zealand Secondary Schools (FRANCS)
The project was supported by a Lottery Health Grant, two grants from the Otago Participatory Science Platform, and AUT Faculty of Health and Environmental Sciences Research Development Funds.
The researchers are grateful for the commitment to the work shown by all participating schools.
A current Health Research Council of New Zealand grant is supporting the development of a concussion website, led by Associate Professor Simon Walters and Dr Anja Zoellner at AUT. The website is due to be launched next month, providing information for schools about concussion and guidelines for supporting pupils with it.
Publication:
Sole, G., Badenhorst, M., Mossman, K., Caya, R., Zoellner, A., Sutherland, C., Skilton, D., Salmon, D., Keung, S., Lucas, P., Thompson, K., & Walters, S.
New Zealand Journal of Physiotherapy
