It’s blowing a hoolie when I arrive on the synthetic grass pitch at Cupar’s Duffus Park.
But the cold, blustery conditions don’t seem to be bothering members of the high flying Howe of Fife Rugby Club first team squad who are in the midst of one of their twice weekly evening training sessions beneath the floodlights.
I’m here to meet Howe of Fife Rugby Club physiotherapist Lianne Brunton who has agreed to put me through a pioneering non-medical test which has been rolled out by the Fife club as a means of reducing concussions.
In her day job, Lianne works full time with ex-Scotland and British Lions physio Stuart Barton in the East Neuk.
But in her part-time Howe physio role, she is helping the Cupar club lead from the front as the first rugby club in Europe to test the pioneering independent research which, if successful, could be rolled out across various sports.
The system, which is being used by the club’s first team, is based on the King-Devick Test pioneered in the USA.
And as The Courier revealed in October, the Cupar club’s ground breaking efforts are attracting media attention from around the world.
“It’s a ‘remove-from-play side line concussion screening test’ that can be administered by parents and coaches in minutes,” explains Lianne, who brought the system to Cupar after being approached by consultant neuropathologist Dr Willie Stewart, of Glasgow’s Queen Elizabeth University Hospital, with whom she worked during her master’s degree dissertation.
“It’s based on the concept that concussions are a complex type of brain injury that are not always visible on routine brain scans.”
Pulling out her tablet for me to work on, Lianne explains that the King-Devick Test is a two-minute test that requires an athlete to read single digit numbers displayed on the screen.
After suspected head trauma, which can slow the brain, the athlete is given the test and if the time needed to complete the test is any longer than the athlete’s baseline test time, the athlete should be removed from play and should be evaluated by a licensed professional.
Lianne has allowed me to take the baseline test in the interests of journalistic research but we agree it would be a bad idea for me to deliberately take a head knock for a before and after comparison!
“You click on the start baseline test and what you’ve got to do is read these numbers aloud from left to right, left to right, all the way down as fast as you can,” she says.
“The first card has horizontal lines. The second card has no lines and the numbers are irregularly spaced. The third card is progressively harder again so the numbers are narrower and not equally spaced.”
Lianne says that during tests with Howe players the average baseline was 42.7 seconds. Results usually range from 32 seconds up to 60 seconds
I get two shots, as is the practice, and start to read – 2, 5, 8, 0, 7, 3, 7, 9, 4, 6, 5and so on.
My first attempt registers at 39.7 seconds. “That’s alright,” says Lianne.
My second attempt is 35.5 seconds. “Good!” says Lianne. “That’s an above average score. That would be your baseline so if you got a head knock in a game we’d take you off and measure you against it.”
Lianne explains that if someone is concussed, it could mean their brain is not working at its optimum level. The test measures the saccadic eye movement, which is the quick simultaneous movement of both eyes. The test also examines speech along with concentration and attention.
She adds: “A lot of these guys (after a knock) will say ‘oh I feel fine’, but they are not, and they want to stay on the pitch for their team. As a matter of fact, they are actually putting their team at a disadvantage because you have one player there who’s not getting back into the line fast enough, who’s creating a gap. If you can show a player they are five seconds slower than their baseline, they might say, ‘oh, ok..’
At the time of this interview, the test has been used three times in real Howe games.
At a recent game against Edinburgh Academicals one of the boys Duncan MacIntyre failed the test and will now be following the Scottish guidelines of minimum seven days’ rest and if symptom free he will commence with the return to play protocol.
And during a recent match at Kelso, former Howe First XV captain Chris Mason, 26, of Cupar, was put through the test for real.
Mason, who has been with the club since his second year at Bell Baxter High School, has been concussed “a couple of times” and says the system could be beneficial as many players didn’t realise the potential dangers of repeated head knocks.
He says the system could be beneficial as many players didn’t realise the potential dangers of repeated head knocks.
He adds: “At our level there is the occasional head knock.
“A couple of my friends got more severe concussion which was a bit more worrying to see.
“The repetitive nature of rugby is probably the most worrying thing.
“Speaking to Lianne, a lot of guys think of concussion as a one-off kind of hit and be aware of that and possibly not the repeat nature of it.”
Vice-captain Dom Martin, 23, of Cupar, who has played with the Howe since he was six, says: “Obviously in the last year or so it has come up quite a lot in the media about how big an issue it is. Until recently it’s probably not been something I’ve been overly concerned about.”
Lianne emphasises that the club still followed the core of the SRU ‘If in doubt sit it out’ guidelines in association with the Scottish Government and sportscotland – the first country to publish national concussion guidelines.
Scottish guidance recommends that for concussed adults the minimum return to sport is 12 days and for under-19s it’s 23 days.
“If there was someone there who was better than their baseline and we thought they had concussion, we would still sit them out,”she adds.
Lianne says the plan was to use the King-Devick Test for the season and see if it was practical.
She adds: “There is a lot of concern about concussion. I have parents asking all the time. Should I get them a mouth guard or a scrum hat? Will that make any difference? The answer is no. There’s no evidence anything like that makes a difference. The last thing we want to do is put children off playing rugby. It’s a brilliant sport. We want everyone to be able to play rugby but you’ve got to make sure you are picking up concussions.
“If you get a concussion and it’s managed properly, there’s no evidence there will be long lasting effects. So parents shouldn’t be worried about letting their children play rugby as long as there are procedures in place.”
Scottish Rugby says it supports any initiative that may assist in enhancing participants well-being.
A spokesman previously said: “This is independent research which may well aid the diagnosis and management of concussion, particularly if it builds on Scottish Rugby’s philosophy, which is centred on the health of the player and raising the awareness of concussion as a serious condition, which can occur both in sport and life generally.
“We believe there should also always be an experienced medical professional to make assessments on the condition of any player and our mantra on concussion remains straight-forward ‘if in doubt, sit them out’.”