IRB reveal Six Nations still not sold on concussion test

The International Rugby Board admitted some countries within the Six Nations were "wary" of adopting the global governing body's controversial pitch-side concussion assessment (PSCA). IRB chief executive Brett Gosper would like the PSCA in use throughout the next edition of the Six Nations, Europe's leading international rugby union tournament, which starts in February. However, the Australian said some countries within the Six Nations, which comprises England, Scotland, Ireland, Wales, France and Italy -- had still to be convinced. First trialled last year, the PSCA allows players to return to match action five minutes after a head injury as long as they have been cleared of concussion by medics. To do so, they must answer a number of questions — without getting any wrong — and pass a balance test, otherwise they cannot return to the fray. Previously, players had had to take three weeks off — a period later reduced to one week — if they suffered suspected concussion. IRB chief medical officer Dr Martin Raftery, alongside Gosper on Monday, stressed the PSCA was designed to be a step-by-step or 'multi-modal' tool to help assess cases in which concussion was not immediately apparent. Raftery re-iterated that if a player was clearly displaying signs of concussion, he shouldn't play on in that same match. The 'multi-modal' approach has been trialled in leading tournaments as England's Premiership and France's Top 14 but has met resistance from the Celtic League. "The Six Nations have not signed on to it yet and we are certainly putting pressure on them to adopt it," said Gosper. "It is possibly because they have problems with PSCA but we will put pressure on those unions who are wary of it that these are the best protocols." However, Gosper added: "We believe so much in it and while yes we can put pressure on the Unions who are not believers, at the end of the day it is their competition." The PSCA's most prominent critic has been former Ireland international Dr Barry O'Driscoll, the uncle of Irish great Brian. O'Driscoll resigned from the IRB's medical board 18 months ago, claiming the issue of concussion was being "trivialised". However, Raftery insisted Monday the PSCA was leading to a reduction in the number of concussed players remaining on the field. "Before with the single modal assessment it was based only on memory and that picked up just 32 percent of concussed players," he said. "In the past 56 percent of concussed players stayed on the pitch, now with PSCA it is down to 13 percent. Is that good? No? Is that perfect? No. Obviously we want to reduce that figure even more." Raftery, formerly the Australia team doctor, also took issue with those who said five minutes was not long enough to properly assess if a player was concussed or not. "Saying five minutes is too short is a poor argument. At the moment it is zero minutes. "Five is better than zero. There isn't any question multi-modal assessment is the answer." The PSCA was called into question during the deciding third Test between Australia and the British and Irish Lions in Sydney in July. Australia flanker George Smith, clearly unsteady after clashing heads with Lions hooker Richard Hibbard in a sickening collision, returned to play after taking the PSCA. IRB chiefs insist Smith should never have taken the PSCA as he was clearly concussed and there was no doubt about his condition. International Rugby Players' Association chief executive Rob Nichol, also in Dublin on Monday, backed Raftery in saying five minutes was long enough for the PSCA and insisted his members weren't trying to 'cheat' the system. "We have had 173 players undergo the PCSA since it started and haven't had one complaint about it being five minutes," Nichol said. "We're pushing our players to be honest guys," the New Zealander added. "Some of the older guys rolled the dice when they were playing and it is only when younger players sit with them and see the after-effects, such as the older lot having been forced to retire early, they understand being honest with the medic is the only option." Source: AFP