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• Caution required in interpretation of findings: Defining and conceptualising ‘sport’ matters
  Jack Hardwicke, Matthew Peter Shaw
  Published on: 10 September 2024

• Published on: 10 September 2024

  Caution required in interpretation of findings: Defining and conceptualising ‘sport’ matters

  • Jack Hardwicke, Senior Lectuter in Sociology of Sport Nottingham Trent University
  • Other Contributors:
    • Matthew Peter Shaw, Senior Lecturer in Sport Science

  Lennon and colleagues report on the associations between sport-related concussion (SRC), non-sports-related concussion (nSRC) and long-term cognitive and behavioural outcomes in a longitudinal cohort of community-dwelling adults. Findings suggest that those with SRC showed no long-term cognitive or behavioural deficits compared with those with no concussions. Moreover, it is suggested those with SRC showed better performance in working memory and verbal reasoning at the study baseline which is hypothesized to be due to the ‘benefits of sport’ in the form of physical, social and economic benefits. The authors suggest these findings will help inform physicians and public health authorities when communicating the risks and benefits of community sports to patients and the public.

  As the authors note, their findings are “at odds with much of the SRC literature”. This is likely a contributing factor to the media coverage of this research. At the time of writing, The Times, The Telegraph and the Guardian have all reported on the studies finding with variations on the benefits of ‘amateur sport’ outweighing the risk of concussion. The NIHR Applied Health Research and Care South West Peninsula, that supported the research, has also hosted a press release titled ‘Sports concussions in non-athletes not linked to long-term brain problems’. There is a common feature to all the press coverage so far: all have used images of adults or children playing what appears to be contact ru...

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  Lennon and colleagues report on the associations between sport-related concussion (SRC), non-sports-related concussion (nSRC) and long-term cognitive and behavioural outcomes in a longitudinal cohort of community-dwelling adults. Findings suggest that those with SRC showed no long-term cognitive or behavioural deficits compared with those with no concussions. Moreover, it is suggested those with SRC showed better performance in working memory and verbal reasoning at the study baseline which is hypothesized to be due to the ‘benefits of sport’ in the form of physical, social and economic benefits. The authors suggest these findings will help inform physicians and public health authorities when communicating the risks and benefits of community sports to patients and the public.

  As the authors note, their findings are “at odds with much of the SRC literature”. This is likely a contributing factor to the media coverage of this research. At the time of writing, The Times, The Telegraph and the Guardian have all reported on the studies finding with variations on the benefits of ‘amateur sport’ outweighing the risk of concussion. The NIHR Applied Health Research and Care South West Peninsula, that supported the research, has also hosted a press release titled ‘Sports concussions in non-athletes not linked to long-term brain problems’. There is a common feature to all the press coverage so far: all have used images of adults or children playing what appears to be contact rugby.

  Any reader would reasonably assume then that this research had a clear focus on ‘contact sports’. Especially so given the senior author is quoted in the NIHR press release explicitly saying, “This study suggests that there could be long-term benefits from sport which could outweigh any negative effects of concussions, which could have important implications for policy decisions around contact sport participation”. But what seems to be missing from the research article is information about exactly what ‘sport’ the participants did across the groups created for analysis.

  In the supplementary material, Table S3 shows the ‘Head injury scenario questions’ used to categorise these groups. Yet little clarity is offered here. The sport-related concussion group appears to have been categorised based on responses to two questions: 1) Have you ever had a blow to the head while biking? (cycling), 2) Have you ever had a blow to the head while playing sports? (football, baseball, basketball etc). This is a very wide category to group as ‘SRC’. Without further clarification, this could plausibly include any of the following head injury events: falling off a bicycle whilst riding to work, falling over playing table tennis, being punched in the head whilst boxing or receiving a high-impact tackle playing rugby. Clearly, the context of each of these varies significantly. Interestingly, this instrument also seems to categorise head injuries sustained from rollerblading/skateboarding, horse riding and skiing as ‘Non-sport related’. Furthermore, given the focus on the benefits of ‘sport’ for long-term cognitive health, it is surprising that the sporting backgrounds of those that were in the ‘nSRC’ and ‘Mixed concussion group’ were not reported.

  The definition and conceptualisation of what constitutes ‘sport’ is not clear in the article which makes interpretation of the findings difficult. ‘Community sport’ is used but what this is referring to is not explained. Given the ongoing public health concerns with brain health in contact sports specifically, accuracy is paramount. We urge the authors to clarify the sporting backgrounds of their participants so the scientific community, policy makers, the public and the media can be better placed to evaluate these findings.

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  Conflict of Interest:
  None declared.

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