Concussion and stress research puts jockey safety in the saddle

The role of a professional jockey is celebrated in Australian sporting culture, but it comes with risks that can have long term impacts on the health of both jockeys and thoroughbred horses – and even prove fatal. A jockey is five times more likely to suffer a concussion than an AFL footballer, and based on death at work statistics, it’s also the second most dangerous job in the world.

Enhanced welfare and safety of thoroughbred horses, those who work with them, and the sustainability of the industry is a key priority the AgriFutures Thoroughbred Horses Program Strategic RD&E Plan (2017-2022). The Program and Racing Victoria have invested in research that investigates how to monitor a jockey after a concussion to inform their recovery and return to work.

The research project ‘Improving jockey safety through the use of virtual reality and biomarkers of concussion’ relied on innovative technology and significant hours in the lab – but builds on common sense.

“We already know that when someone is stressed, their decision-making skills are adversely impacted – and research into this field was initially based on that knowledge,” said research lead Dr Brad Wright.

Based at the School of Psychology and Public Health at Melbourne’s La Trobe University, Dr Wright led a team of researchers to find out how a jockey’s high stress workplace could be related to the rate at which they hurt themselves.

“We started analysing data and could see that stress was leading to physiological changes that impact decision-making, which then leads to inattention and ultimately to injury and concussion,” he said.

“That led us to look at tests that are used to decide if a jockey is fit to return to work following a concussion, and we found that the pen and paper tests or even computer-based tests received push back from jockeys because it wasn’t a true representation of the stress they face on the track.

“We were concerned that jockeys could potentially return to work prematurely, based on cognitive tests that simply didn’t apply to their workplace.”

The other critical study areas relate to insights held in blood biomarkers in concussion victims and history of concussions.

“We know that following high level brain trauma there’s a release of certain proteins that give an indication that the brain has been damaged, but with concussion the evidence around this is less clear,” Dr Wright said.

With the assistance of researchers at Monash University, led by Dr Stuart McDonald of the Monash Trauma Group, the project team searched for biomarkers specific to concussion.

“We looked at some newer, more novel biomarkers – specifically neurofilament light (NFL) protein –and we found that this biomarker was still at high levels in a jockey’s blood stream up to a month later,” Dr Wright said.

“This is a major finding because while these jockeys may not have headaches or nausea anymore, and they could successfully pass their return-to-work tests, the biomarkers tell us that the injury remains.

“In this case, if the rider has another fall it’s likely that the second concussion, on top of the pre-existing unresolved concussion, will lead to more severe outcomes.”

It’s a significant scientific finding and Dr Wright admits it is also incredibly concerning.

Enter Virtual Reality (VR) – a post-concussion test that requires the jockey to wear a VR headset simulating a real-life track scenario.
The technology places the participant in a virtual horse race where they must respond to stimuli that assesses their visual processing speed, attention and decision-making by tracking eye speed and manual reaction times, ultimately looking for signs of potential dysfunction in the central nervous system.

“Essentially, we were putting them in a horse race without putting the rider or horse at risk,” Dr Wright said.

“We measured participant responses and gauged their levels of stress. If they found it too challenging or scores were low then we have good evidence to suggest that they should not go back to the track, and to recommend a retest in a few weeks.”

“We’ve done a lot of work with VR testing over the past four years with other sportspeople, so there is a lot of reliable and valid data to support these findings,” he said.

“This project has shown us that jockeys who have incurred a higher number of concussions performed more poorly over time in cognitive tests than those with less concussions – evident by slower responses over a testing timeframe of a few years – and that’s something we’d like to look closer at.

“Ultimately, we want to form a test group of jockeys that we can monitor prior to suffering a concussion through to a year after sustaining the injury – this will hopefully provide insight into changes that occur in the brain during recovery.”

Dr Wright said the research findings so far are still only the tip of the iceberg, with the studies likely to have major applications to other athletes, through to those serving in the defence force or doing long, intense shifts at work.

“We have received a lot of industry support – but there are still big questions to be answered around reducing mortality and morbidity in high stress workplaces,” he said.

To read the full report visit https://agrifutures.com.au/product/final-report-summary-improving-jockey-safety-through-the-use-of-virtual-reality-and-biomarkers-of-concussion/