Understanding the impact of sport-related concussion and physical pain on mental health, cognitive ability, and quality of life


Student thesis: Doctoral Thesis


An issue within concussion research is that it often overlooks the role of physical pain. Poor
mental health, impaired cognitive ability, and reduced quality of life are all associated with
concussion. However, these three broad outcomes are also linked with experiencing physical
pain, and therefore this project aimed to better understand whether concussion or physical
pain is responsible for these negative outcomes. Studies 1 and 2 suggest that physical pain is
greatly linked with poorer mental health and reduced quality of life, while study 3
corroborates these findings and adds that concussion history is more responsible for cognitive
impairment. Study 4 highlighted some of the issues with remote cognitive testing across
different time-points but further emphasised the importance of assessing physical pain in
athletes with and without history of concussion. Study 5 emphasised the dangers of taking
part in contact sports, with women, those in physical pain, those that have previously
sustained sport-related concussion (SRC) and those that engage in contact sports significantly
more likely to develop depression. Based on the findings from studies 1-5, we wanted to
understand why those that take part in contact sports where SRC is common, do so and
therefore study 6 interviewed amateur rugby players to investigate their attitudes and
knowledge base of concussion. Poor duty of care may be prevalent in amateur rugby, which
can result in poor attitudes and knowledge increasing the chance of continuing participation
following a suspected concussion. An increased emphasis on improving duty of care could
relieve these poor attitudes and the behaviour following suspected concussion. Finally,
although physical pain is key in findings of studies 1-5, the way in which we measured this
may be limited and we therefore propose a new Localised Pain Scale that could be more
robust. Overall, this thesis refines what we currently know about the effects of concussion
and physical pain by highlighting the outcomes associated with both.
Date of Award3 Apr 2023
Original languageEnglish
Awarding Institution
  • Edge Hill University
SupervisorADAM QURESHI (Supervisor), DAVID MARCHANT (Supervisor) & ALEX BAHRAMI BALANI (Director of Studies)


  • Sport-related concussion
  • Physical pain
  • Mental health
  • Cognitive ability
  • Quality of life

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