2071 A Video Analysis of Concussion and Return to Play Among Athletes Following 333 Slaps

INTRODUCTION: Slapfighting is a combat sport wherein athletes inflict high-powered slaps to the head against each other. The structured setup of the Power Slap promotion removes some of the obstacles seen with other combat sports, permitting detailed analysis of the clinical outcomes yielded by each slap. METHODS: VA of Power Slap was performed by four reviewers, observing for number of slaps in a match, the result of each slap/match, occurrence of a VSC (i.e. slow to get up, motor incoordination, loss of responsiveness/consciousness, clutching at head/face, blank/vacant look, impact seizure, vomiting, visible facial injury, amnesia), return to play time (expiration of recovery clock), and second impact (when a participant showed a VSC, after already showing signs following a previous slap). Inter-rater reliability was calculated using Cohen’s d. RESULTS: A total of 333 slaps were analyzed; the most common signs included motor incoordination (interrater reliability: 0.78), blank vacant look (interrater reliability: 0.74), and slow to get up (interrater reliability: 0.78). VSCs were observed in 97 (29.1%) slaps. Twenty occurrences of second impact were observed. Following a VSC, mean return to play was 31.8 seconds. Defenders who exhibited a VSC were more likely to lose the match (β = 1.515, 95% CI 0.552 to 2.574, p = 0.004) compared to defenders who did not. CONCLUSIONS: Power Slap athletes exhibit numerous signs of concussion, the most common of which is motor incoordination. Due to the alarming rate of signs observed that are indicative of concussions, slapfighting may be a more grievous combat sport than previously assumed, and strategies to optimize the neurologic health of these athletes should be pursued.