Former England international rugby players are set to be recruited for the next phase of a major-scientific study examining the possible long-term effects of the game on brain health. 

The Rugby Football Union, together with leading academics from the London School of Hygiene & Tropical Medicine, Queen Mary University of London, The Institute of Occupational Medicine, University College London and Oxford University will study the possible link between a history of concussion and neurodegenerative disease in former rugby players. The Drake Foundation has committed over £450,000 to funding this research.

Our data is beginning to provide us with a clearer picture of player health long-term, and concussion is one aspect of many that need to be expanded in terms of what is currently known and not yet known within rugby.

Madi Davies, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

The project aims to provide a greater amount of information on the potential medium and long-term neurocognitive risks of playing rugby than is currently available from other studies.It also shows rugby continues to provide a leading and proactive role in this important medical and player welfare area.

This will follow on from a study conducted in the past 18 months by researchers from the Oxford Centre for Sport, Exercise and Osteoarthritis, which included a survey of approximately 300 former England players as well as Oxford and Cambridge University players. Detailed information was collected on their playing history, past injuries including concussions sustained during their career, and their current musculoskeletal and general health. Data analysis from this Phase 1 Player Health Study is underway and results are expected to be released later this autumn.

This new study is designed to assess the potential association between a history of concussion and general and neurological health. It will begin shortly and will involve approximately 200 participants over the age of 50 who participated in the previous study.

The more in-depth research will gather additional data on the retired players' quality of life and social circumstances, with an extensive set of tests capturing physical and cognitive capabilities and a neurological clinical examination. There will also be face-to-face assessments as well as blood and urine samples taken for future analysis.

The same tests and procedures will be used in a separate ongoing 1946 Birth Cohort Study which will provide a general population comparison.

Lead Oxford researcher Madi Davies commented: 'This is an excellent opportunity to build on what we are learning from our former players about their musculoskeletal and overall health. Our data is beginning to provide us with a clearer picture of player health long-term, and concussion is one aspect of many that need to be expanded in terms of what is currently known, and not yet known within rugby union.'

Evidence is accumulating on the possible increased risks of neurodegenerative diseases including Dementia, Amyotrophic Lateral Sclerosis (ALS), Parkinson’s disease (PD), Dementia and Chronic Traumatic Encephalopathy (CTE) in former contact sport athletes.

Different sports expose players to different types of injuries and while several studies have suggested an increased risk of various neurological disorders, this has not yet been established.

Simon Kemp Chief Medical Officer at the RFU said: 'The RFU has worked extremely hard to increase the education of those involved in the game about concussion and to improve the management of the risk of the injury based on the evidence available. The next step for us a union and as a sport is progress beyond delivering 'recognise, remove, recover and return' and try to understand more about the possible longer-term effects on the health of the brain. We welcome the support from the Drake Foundation, the academic institutions involved in the project and the former players who will take part in the study.'

Former England International Rob Andrew who took part in the first phase of the research, said: 'As a former professional rugby player I believe it is really important that we all understand the potential long-term health outcomes from playing the sport at a high level.

'This study will provide an insight into the health of former players, which can only be a good thing in terms of players being more informed, but also helping the sport look at how to manage both the short and long-term risks associated with injury.'

Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis Deputy Director and Professor of Rheumatology, Nigel Arden added: 'The Arthritis Research UK Centre for Sport is examining player health across many sports, with a view to understanding the health benefits and deficits which may affect players in later life. We are thrilled to be joining forces in this collaboration to further examine cognition, mobility and health amongst this unique group.'

In addition to having recruited former England players, researchers are also keen to hear from former recreational players. Madi Davies explained: 'As we look forward to the next phase of this study, we are keen to understand not only elite but equally how recreational players may be functioning in later life. Recreational players are the majority of players, and also those who are contributing to a potential health burden here.'