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Bailey SJ, Martindale R, Engebretsen L, Robson JP, Palmer D. Epidemiology of International Match Injuries in Scottish Rugby: A Prospective Cohort Study. Int J Sports Med 2023; 44:805-812. [PMID: 37279793 DOI: 10.1055/a-2038-3452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fifteen-a-side rugby union ("rugby") is a full-contact sport played separately by men and women, with large injury incidences reported previously. Context specific injury surveillance fulfils governing bodies' duty of care to understand risks to player welfare, yet no contemporary match injury epidemiology studies exist for international players in Scotland. The current study therefore aimed to describe the incidence, severity, burden and nature of match injuries sustained by Scotland's men's and women's national teams. A prospective cohort study of injuries recorded in matches across the 2017/18 and 2018/19 seasons was undertaken, with injury and exposure definitions in line with the international consensus for injury surveillance in rugby. Injury incidence was 120.0 (men) and 166.7/1,000 player match hours (women), injury severity was 12.0 (median) and 31.2 days (mean) for men, and 11.0 (median) and 30.2 days (mean) for women. Injury burden was 3,745 (men) and 5,040 days absence/1,000 player match hours (women). Concussion was the most common specific injury for men (22.5/1,000 hours) and women (26.7/1,000 hours). No statistical differences were found for incidence or severity measures between sexes. Injury incidence was greater than recent Rugby World Cup studies. High incidences of concussion reinforces the need for prevention strategies targeting this injury.
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Affiliation(s)
- Stuart John Bailey
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Russell Martindale
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Lars Engebretsen
- Orthopedic Clinic, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - James Peter Robson
- Sport Medicine, Scottish Rugby Union, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Debbie Palmer
- Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, United Kingdom of Great Britain and Northern Ireland
- School of Medicine, University of Nottingham School of Medicine, Nottingham, United Kingdom of Great Britain and Northern Ireland
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Starling LT, Gabb N, Williams S, Kemp S, Stokes KA. Longitudinal study of six seasons of match injuries in elite female rugby union. Br J Sports Med 2023; 57:212-217. [PMID: 36428090 DOI: 10.1136/bjsports-2022-105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
ObjectiveTo establish match injury rates and patterns in elite female rugby union players in England. METHOD We conducted a six-season (2011/2012-2013/2014 and 2017/2018-2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used. RESULTS Five-hundred and thirty-four time-loss injuries were recorded during 13 680 hours of match exposure. Injury incidence was 39 injuries per 1000 hours (95% CIs 36 to 42) with a mean severity of 48 days (95% CIs 42 to 54) and median severity of 20 days (IQR: 7-57). Concussion was the most common specific injury diagnosis (five concussions per 1000 hours, 95% CIs 4 to 6). The tackle event was associated with the greatest burden of injury (615 days absence per 1000 hours 95% CIs 340 to 1112), with 'being tackled' specifically causing the most injuries (28% of all injuries) and concussions (22% of all concussions). CONCLUSIONS This is the first multiple-season study of match injuries in elite women's rugby union players. Match injury incidence was similar to that previously reported within international women's rugby union. Injury prevention strategies centred on the tackle would focus on high-burden injuries, which are associated with substantial player time-loss and financial costs to teams as well as the high-priority area of concussions.
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Affiliation(s)
| | - Niki Gabb
- Department for Health, University of Bath, Bath, UK
| | | | - Simon Kemp
- Medical Services, Rugby Football Union, Twickenham, UK
| | - Keith A Stokes
- Department for Health, University of Bath, Bath, UK .,Medical Services, Rugby Football Union, Twickenham, UK
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3
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Murias-Lozano R, San Sebastián-Obregón FJ, Lucio-Mejías H, Saló-Cuenca JC, Plaza-Manzano G, López-de-Uralde-Villanueva I, Maté-Muñoz JL, García-Fernández P. Match Injuries in the Spanish Rugby Union Division de Honor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11861. [PMID: 36231172 PMCID: PMC9565692 DOI: 10.3390/ijerph191911861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To describe the injury rate, severity, cause, anatomical location (tissue damaged), recurrence, place and time during matches throughout a season in the Spanish Rugby Union Division de Honor. METHODS Observational, prospective and descriptive study conducted in the competition of the Spanish División de Honor de Rugby with 258 players. The data were reported by the medical services of the previously formed clubs. RESULTS Total exposure was 4100 h, during which 220 injuries occurred. The average number of sick days was 36.8. The total injury rate was 53.6 injuries/1000 h of exposure. Three quarters suffered 93 injuries and the forwards sustained a total of 127 injuries, with a total of 48.6 and 58.1 injuries/1000 h of exposure, respectively. Moderate injuries were the most frequent. Specifically, ligament injury was the most frequent, and dislocation was the injury that caused the most sick days. The most injuries occurred in the third quarter of the match, and the most serious injuries occurred in the second quarter. CONCLUSIONS The injury rate of Spanish rugby competitors is 53.6 injuries/1000 match hours, with an average of 36.8 sick days. Contact injuries are the most frequent, taking place especially when tackling or being tackled.
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Affiliation(s)
- Roberto Murias-Lozano
- Department of Physiotherapy, Camilo José Cela University, Villafranca del Castillo, 28692 Madrid, Spain
- Spanish Rugby Federation, 28008 Madrid, Spain
- Physioactive Clinic, 28002 Madrid, Spain
| | | | - Henar Lucio-Mejías
- Department of Physiotherapy, Camilo José Cela University, Villafranca del Castillo, 28692 Madrid, Spain
- Spanish Rugby Federation, 28008 Madrid, Spain
- Physioactive Clinic, 28002 Madrid, Spain
| | - José Carlos Saló-Cuenca
- Traumatology Unit, Orthopaedic Surgery and Traumatology Service, University Hospital Arnau de Vilanova, 25198 Lleida, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - José Luis Maté-Muñoz
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
| | - Pablo García-Fernández
- Department of Radiology, Rehabilitation and Physiotherapy, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Stitt D, Kabaliuk N, Alexander K, Draper N. Drop Test Kinematics Using Varied Impact Surfaces and Head/Neck Configurations for Rugby Headgear Testing. Ann Biomed Eng 2022; 50:1633-1647. [PMID: 36002780 DOI: 10.1007/s10439-022-03045-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/28/2022]
Abstract
World Rugby employs a specific drop test method to evaluate headgear performance, but almost all researchers use a different variation of this method. The aim of this study was, therefore, to quantify the differences between variations of the drop testing method using a Hybrid III headform and neck in the following impact setups: (1) headform only, with a flat steel impact surface, approximating the World Rugby method, (2 and 3) headform with and without a neck, respectively, onto a flat MEP pad impact surface, and (4) headform and neck, dropped onto an angled MEP pad impact surface. Each variation was subject to drop heights of 75-600 mm across three orientations (forehead, side, and rear boss). Comparisons were limited to the linear and rotational acceleration and rotational velocity for simplicity. Substantial differences in kinematic profile shape manifested between all drop test variations. Peak accelerations varied highly between variations, but the peak rotational velocities did not. Drop test variation also significantly changed the ratios of the peak kinematics to each other. This information can be compared to kinematic data from field head impacts and could inform more realistic impact testing methods for assessing headgear.
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Affiliation(s)
- Danyon Stitt
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.,Sport Health and Rehabilitation Research Centre (SHARRC), University of Canterbury, Christchurch, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand. .,Sport Health and Rehabilitation Research Centre (SHARRC), University of Canterbury, Christchurch, New Zealand.
| | - Keith Alexander
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.,Sport Health and Rehabilitation Research Centre (SHARRC), University of Canterbury, Christchurch, New Zealand
| | - Nick Draper
- Faculty of Health, University of Canterbury, Christchurch, New Zealand.,Sport Health and Rehabilitation Research Centre (SHARRC), University of Canterbury, Christchurch, New Zealand
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Heyward O, Emmonds S, Roe G, Scantlebury S, Stokes K, Jones B. Applied sports science and sports medicine in women’s rugby: systematic scoping review and Delphi study to establish future research priorities. BMJ Open Sport Exerc Med 2022; 8:e001287. [PMID: 35979431 PMCID: PMC9310180 DOI: 10.1136/bmjsem-2021-001287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/04/2022] Open
Abstract
ObjectivesIn part 1, the objective was to undertake a systematic scoping review of applied sports science and sports medicine in women’s rugby, and in part 2 to develop a consensus statement on future research priorities.DesignIn part 1, a systematic search of PubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost) was undertaken from the earliest records to January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, the PRISMA extension for Scoping Reviews, and the PRISMA extension protocols were followed. In part 2, 31 international experts in women’s rugby (ie, elite players, sports scientists, medical clinicians, sports administrators) participated in a three-round Delphi consensus method. These experts reviewed the findings from part 1 and subsequently provided a list of priority research topics in women’s rugby. Research topics were grouped into expert-based themes and expert-based subthemes via content analysis. Expert-based themes and expert-based subthemes were ranked from very low to very high research priority on a 1–5 Likert scale. Consensus was defined by ≥70% agreement. The median research priority agreement and IQR were calculated for each expert-based theme and subtheme.Data sourcesPubMed (MEDLINE), Scopus and SPORTDiscus (EBSCOhost).Eligibility criteria for selecting studiesStudies were eligible for inclusion if they investigated applied sports science or sports medicine in women’s rugby.ResultsIn part 1, the systematic scoping review identified 123 studies, which were categorised into six sports science and sports medicine evidence-based themes: injury (n=48), physical performance (n=32), match characteristics (n=26), fatigue and recovery (n=6), nutrition (n=6), and psychology (n=5). In part 2, the Delphi method resulted in three expert-based themes achieving consensus on future research priority in women’s rugby: injury (5.0 (1.0)), female health (4.0 (1.0)) and physical performance (4.0 (1.0)).Summary/ConclusionThis two-part systematic scoping review and Delphi consensus is the first study to summarise the applied sports science and sports medicine evidence base in women’s rugby and establish future research priorities. The summary tables from part 1 provide valuable reference information for researchers and practitioners. The three expert-based themes that achieved consensus in part 2 (injury, female health and physical performance) provide clear direction and guidance on future research priorities in women’s rugby. The findings of this two-part study facilitate efficient and coordinated use of scientific resources towards high-priority research themes relevant to a wide range of stakeholders in women’s rugby.
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The Incidence, Cost, and Burden of Concussion in Women's Rugby League and Rugby Union: A Systematic Review and Pooled Analysis. Sports Med 2022; 52:1751-1764. [PMID: 35113388 PMCID: PMC9325800 DOI: 10.1007/s40279-022-01645-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 11/05/2022]
Abstract
Background The extent of concussion injury in the rugby codes for women is unclear. Objective Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women’s concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results The pooled analysis match injury incidence of women’s concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women’s rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women’s rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women’s rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01645-8.
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Stitt D, Kabaliuk N, Alexander K, Draper N. Potential of Soft-Shell Rugby Headgear to Mitigate Linear and Rotational Peak Accelerations. Ann Biomed Eng 2022; 50:1546-1564. [DOI: 10.1007/s10439-022-02912-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/01/2022] [Indexed: 11/30/2022]
Abstract
AbstractRugby union is a popular sport played across the world. The physical contact inherent in the game means that players are at increased risk of concussive injury. In 2019, World Rugby created a new category of permitted headgear under Law 4 as a medical device. This established a pathway for headgear designed to reduce peak accelerations to be worn in matches. Investigations of the potential of soft-shelled protective headgear to reduce head impact accelerations have been mostly limited to the analysis of linear kinematics. However rotational head impact accelerations have long been implicated as far more injurious. The aim of this study, therefore, was to assess the linear and rotational acceleration reduction brought about by soft-shelled rugby headgear. A Hybrid III headform and neck were dropped onto a modular elastomer programmer impact surface, impacting at four different velocities (1.7–3.4 m/s) in five different impact orientations. Impact surface angles were 0°, 30°, and 45°. Peak linear and rotational accelerations, PLA and PRA respectively, were recorded. All headgear significantly reduced PLAs and PRAs when compared to a no headgear scenario. The new generation, headgear reduced all measures significantly more than the older generation of headgear. Impact locations offset from the center of mass of the headform resulted in the highest PRAs measured. As the impact surface angle increased, both PLAs and PRAs decreased. The study demonstrated that headgear tested lowered PLAs by up to 50%, and PRAs by up to 60% compared to the bare headform. Our data suggest that new generation headgear could make a difference on the field in reducing injurious impact accelerations in a collision.
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8
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Takamori S, Hamlin MJ, King D, Hume PA, Tachikawa K, Koyanagi R, Yoshida T. Profiling the tackle and its injury characteristics in premier New Zealand club rugby union players over a complete season. Br J Sports Med 2022; 56:778-784. [DOI: 10.1136/bjsports-2021-104868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/03/2022]
Abstract
ObjectivesRugbySmart is a safe tackle technique education programme. Our objective was to identify whether the RugbySmart-recommended safe tackle technique was exhibited by club rugby players and whether tackle-related injuries showed poor tackle technique characteristics.MethodsThe prospective cohort design enabled 28 senior club based amateur male rugby union players from New Zealand to be followed over 18 matches in the 2017 rugby season. Game video analysis by three analysts provided categorisation of tackle technique into type, approach, foot contact, leading foot and rear foot position, face and head position. Injuries were diagnosed by the same sports medicine physician.ResultsIn the 18 matches, 28 players completed a combined total of 3006 tackles, with only six tackle-related injuries sustained. Notable findings included: (1) forwards complete more tackles than backs; (2) shoulder tackles were the most prevalent tackle; (3) good tackle technique as promoted by RugbySmart was demonstrated in 57.9% of all tackles and (4) of the six tackle-related injuries, two occurred despite RugbySmart desired tackle techniques.ConclusionThis is the first study to investigate whether players were performing the recommended ‘safe tackle technique’ proposed by New Zealand Rugby’s RugbySmart programme. As two of six tackle-related injuries occurred despite the RugbySmart preferred technique being performed, further technique analysis and a larger sample are needed to determine what techniques reduce risk of injury during tackles. As only 57.9% of tackles were performed with RugbySmart head and foot positions, further research and education regarding tackle technique recommendations are needed.
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9
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Symons GF, Clough M, Fielding J, O'Brien WT, Shepherd CE, Wright DK, Shultz SR. The Neurological Consequences of Engaging in Australian Collision Sports. J Neurotrauma 2021; 37:792-809. [PMID: 32056505 DOI: 10.1089/neu.2019.6884] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Collision sports are an integral part of Australian culture. The most common collision sports in Australia are Australian rules football, rugby union, and rugby league. Each of these sports often results in participants sustaining mild brain traumas, such as concussive and subconcussive injuries. However, the majority of previous studies and reviews pertaining to the neurological implications of sustaining mild brain traumas, while engaging in collision sports, have focused on those popular in North America and Europe. As part of this 2020 International Neurotrauma Symposium special issue, which highlights Australian neurotrauma research, this article will therefore review the burden of mild brain traumas in Australian collision sports athletes. Specifically, this review will first provide an overview of the consequences of mild brain trauma in Australian collision sports, followed by a summary of the previous studies that have investigated neurocognition, ocular motor function, neuroimaging, and fluid biomarkers, as well as neuropathological outcomes in Australian collision sports athletes. A review of the literature indicates that although Australians have contributed to the field, several knowledge gaps and limitations currently exist. These include important questions related to sex differences, the identification and implementation of blood and imaging biomarkers, the need for consistent study designs and common data elements, as well as more multi-modal studies. We conclude that although Australia has had an active history of investigating the neurological impact of collision sports participation, further research is clearly needed to better understand these consequences in Australian athletes and how they can be mitigated.
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Affiliation(s)
- Georgia F Symons
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Meaghan Clough
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Joanne Fielding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - William T O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Claire E Shepherd
- Neuroscience Research Australia, The University of New South Wales, Sydney, New South Wales, Australia
| | - David K Wright
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Sandy R Shultz
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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Draper N, Kabaliuk N, Stitt D, Alexander K. Potential of Soft-Shelled Rugby Headgear to Reduce Linear Impact Accelerations. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5567625. [PMID: 33981403 PMCID: PMC8088347 DOI: 10.1155/2021/5567625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to examine the potential of soft-shelled rugby headgear to reduce linear impact accelerations. A hybrid III head form instrumented with a 3-axis accelerometer was used to assess headgear performance on a drop test rig. Six headgear units were examined in this study: Canterbury Clothing Company (CCC) Ventilator, Kukri, 2nd Skull, N-Pro, and two Gamebreaker headgear units of different sizes (headgears 1-6, respectively). Drop heights were 238, 300, 610, and 912 mm with 5 orientations at each height (forehead, front boss, rear, rear boss, and side). Impact severity was quantified using peak linear acceleration (PLA) and head injury criterion (HIC). All headgear was tested in comparison to a no headgear condition (for all heights). Compared to the no headgear condition, all headgear significantly reduced PLA and HIC at 238 mm (16.2-45.3% PLA and 29.2-62.7% HIC reduction; P < 0.0005, η p 2 = 0.987-0.991). Headgear impact attenuation lowered significantly as the drop height increased (32.4-5.6% PLA and 50.9-11.7% HIC reduction at 912 mm). There were no significant differences in PLA or HIC reduction between headgear units 1-3. Post hoc testing indicated that headgear units 4-6 significantly outperformed headgear units 1-3 and additionally headgear units 5 and 6 significantly outperformed headgear 4 (P < 0.05). The lowest reduction PLA and HIC was for impacts rear orientation for headgear units 1-4 (3.3 ± 3.6%-11 ± 5.8%). In contrast, headgear units 5 and 6 significantly outperformed all other headgear in this orientation (P < 0.0005, η p 2 = 0.982-0.990). Side impacts showed the greatest reduction in PLA and HIC for all headgear. All headgear units tested demonstrated some degree of reduction in PLA and HIC from a linear impact; however, units 4-6 performed significantly better than headgear units 1-3.
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Affiliation(s)
- Nick Draper
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Danyon Stitt
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
| | - Keith Alexander
- Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
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11
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King D, Hume PA, Clark T, Foskett A, Barnes MJ. Training injury incidence in an amateur women's rugby union team in New Zealand over two consecutive seasons. J Sci Med Sport 2020; 24:544-548. [PMID: 33243595 DOI: 10.1016/j.jsams.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To describe the training injury incidence in amateur women's rugby union in New Zealand over two consecutive seasons. DESIGN A prospective cohort observational study METHODS: A total of 69 amateur women's rugby 15s team playerswere observed. Training exposure and training injury incidence were calculated. RESULTS The 38 training injuries resulted in a total injury incidence of 11.4 (8.3-15.6) per 1,000 training-hours. There were 12 injuries that resulted in a time-loss injury incidence of 3.6 (95% CI: 2.0-6.3) per 1,000 training-hours. Forwards recorded more total (RR: 1.8 [95% CI: 0.9-3.5]; p=0.0516) and time-loss (RR: 2.0 [95% CI: 0.6-6.6]; p=0.2482) injuries than Backs. The tackle was the most common injury cause for total (3.0 [95% CI: 1.6-5.6] per 1,000 training-hours.) injuries, but collisions (1.5 [95% CI: 0.6-3.6] per 1,000 training-hours.) with the ground or another person were the most common cause for time-loss injuries.The training injuries occurred most often to the lower limb and during the latter part of training sessions. These injuries were mostly minor in nature resulting in minimal time-loss away from training. DISCUSSION The time-loss injury incidence (3.6 per 1,000 training-hours.) for the amateur women's rugby 15s team players was higher than that reported for National (1.2 per 1,000 training-hours.) and Rugby World Cup for women (0.2 to 3.0 per 1,000 training-hours.) competitions. CONCLUSION The training injury incidence in amateur women's rugby union in New Zealand was higher than that reported for national and international rugby union injury incidences.
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Affiliation(s)
- D King
- School of Sport, Exercise and Nutrition, Massey University, New Zealand; School of Science and Technology, University of New England, Australia; Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, New Zealand; Traumatic Brain Injury Network (TBIN), Auckland University of Technology, New Zealand.
| | - P A Hume
- Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, New Zealand; National Institute of Stroke and Applied Neuroscience (NISAN), Faculty of Health and Environmental Science, Auckland University of Technology, New Zealand; Traumatic Brain Injury Network (TBIN), Auckland University of Technology, New Zealand
| | - T Clark
- International College of Management Sydney, Australia
| | - A Foskett
- School of Sport, Exercise and Nutrition, Massey University, New Zealand
| | - M J Barnes
- School of Sport, Exercise and Nutrition, Massey University, New Zealand
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12
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King D, Hume P, Cummins C, Pearce A, Clark T, Foskett A, Barnes M. Match and Training Injuries in Women's Rugby Union: A Systematic Review of Published Studies. Sports Med 2020; 49:1559-1574. [PMID: 31292854 DOI: 10.1007/s40279-019-01151-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is a paucity of studies reporting on women's injuries in rugby union. OBJECTIVE The aim of this systematic review was to describe the injury epidemiology for women's rugby-15s and rugby-7s match and training environments. METHODS Systematic searches of PubMed, SPORTDiscus, Web of Science Core Collection, Scopus, CINAHL(EBSCO) and ScienceDirect databases using keywords. RESULTS Ten articles addressing the incidence of injury in women's rugby union players were retrieved and included. The pooled incidence of injuries in women's rugby-15s was 19.6 (95% CI 17.7-21.7) per 1000 match-hours (h). Injuries in women's rugby-15s varied from 3.6 (95% CI 2.5-5.3) per 1000 playing-h (including training and games) to 37.5 (95% CI 26.5-48.5) per 1000 match-h. Women's rugby-7s had a pooled injury incidence of 62.5 (95% CI 54.7-70.4) per 1000 player-h and the injury incidence varied from 46.3 (95% CI 38.7-55.4) per 1000 match-h to 95.4 (95% CI 79.9-113.9) per 1000 match-h. The tackle was the most commonly reported injury cause with the ball carrier recording more injuries at the collegiate [5.5 (95% CI 4.5-6.8) vs. 3.5 (95% CI 2.7-4.6) per 1000 player-game-h; χ2(1) = 6.7; p = 0.0095], and Women's Rugby World Cup (WRWC) [2006: 14.5 (95% CI 8.9-23.7) vs. 10.9 (95% CI 6.2-19.2) per 1000 match-h; χ2(1) = 0.6; p = 0.4497; 2010: 11.8 (95% CI 6.9-20.4) vs. 1.8 (95% CI 0.5-7.3) per 1000 match-h; χ2(1) = 8.1; p = 0.0045] levels of participation. Concussions and sprains/strains were the most commonly reported injuries at the collegiate level of participation. DISCUSSION Women's rugby-7s had a higher un-pooled injury incidence than women's rugby-15s players based on rugby-specific surveys and hospitalisation data. The incidence of injury in women's rugby-15s and rugby-7s was lower than men's professional rugby-15s and rugby-7s competitions but similar to male youth rugby-15s players. Differences in reporting methodologies limited comparison of results. CONCLUSION Women's rugby-7s resulted in a higher injury incidence than women's rugby-15s. The head/face was the most commonly reported injury site. The tackle was the most common cause of injury in both rugby-7s and rugby-15s at all levels. Future studies are warranted on injuries in women's rugby-15s and rugby-7s. PROSPERO REGISTRATION NUMBER CRD42018109054 (last updated on 17 January 2019).
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Affiliation(s)
- Doug King
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
- Sport Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand.
- School of Science and Technology, University of New England, Armidale, NSW, Australia.
| | - Patria Hume
- Sport Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand
- National Institute of Stroke and Applied Neuroscience (NISAN), Faculty of Health and Environment Science, Auckland University of Technology, Auckland, New Zealand
| | - Cloe Cummins
- School of Science and Technology, University of New England, Armidale, NSW, Australia
- Institute for Sport Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
- National Rugby League, Sydney, Australia
| | - Alan Pearce
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Trevor Clark
- Sports Performance, Faculty of Human Performance, Australian College of Physical Education, Sydney Olympic Park, NSW, Australia
| | - Andrew Foskett
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Matt Barnes
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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Burger N, Lambert M, Hendricks S. Lay of the land: narrative synthesis of tackle research in rugby union and rugby sevens. BMJ Open Sport Exerc Med 2020; 6:e000645. [PMID: 32518671 PMCID: PMC7254146 DOI: 10.1136/bmjsem-2019-000645] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2020] [Indexed: 01/27/2023] Open
Abstract
Objectives The purpose of this review was to synthesise both injury prevention and performance tackle-related research to provide rugby stakeholders with information on tackle injury epidemiology, including tackle injury risk factors and performance determinants, and to discuss potential preventative measures. Design Systematic review and narrative synthesis. Data sources PubMed, Scopus and Web of Science. Eligibility criteria Limited to peer-reviewed English-only publications between January 1995 and October 2018. Results A total of 317 studies were identified, with 177 in rugby union and 13 were in rugby sevens. The tackle accounted for more than 50% of all injuries in rugby union and rugby sevens, both at the professional level and at the lower levels, with the rate of tackle injuries higher at the professional level (mean 32/1000 player-hours) compared with the lower levels (mean 17/1000 player-hours). A player’s tackle actions and technical ability were identified as major risk factors for injury and a key determinant of performance. Summary/conclusion Evidence-based education, progressive tackle technique training with a high potential to transfer and law changes have been proposed as key modifiers of player tackle actions and technical ability. Conceivably, all three modifiers working in unison (as opposed to separately) will have a higher potential at reducing tackle injury risk while enhancing performance. With the guidance of tackle injury and performance studies, as well as stakeholder engagement, experiential and explorative tackle research has the potential to inspire innovative injury prevention and performance strategies.
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Affiliation(s)
- Nicholas Burger
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Mike Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa.,Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sharief Hendricks
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, Western Cape, South Africa.,Institute for Sport, Physical Activity and Leisure, Centre for Sport Performance, School of Sport, Fairfax Hall, Headingley Campus, Leeds Beckett University, Leeds, West Yorkshire, UK
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14
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Female rugby union injuries in New Zealand: A review of five years (2013–2017) of Accident Compensation Corporation moderate to severe claims and costs. J Sci Med Sport 2019; 22:532-537. [DOI: 10.1016/j.jsams.2018.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/24/2022]
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Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review. Sports Med 2018; 48:953-969. [PMID: 29349651 DOI: 10.1007/s40279-017-0854-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although injuries to the head represent a small proportion of all sport injuries, they are of great concern due to their potential long-term consequences, which are even suspected in mild traumatic brain injuries. OBJECTIVE The aim of this review was to compare the incidence of concussions and other head injuries in elite level football, rugby, ice hockey and American Football. METHODS Four electronic databases (CINAHL, PsycINFO, Web of Science, PubMed) were searched. Prospective cohort studies on the incidence of concussion in elite athletes aged 17 years or older that were published in an English-language peer-reviewed journal since 2000 were included. Two authors independently evaluated study eligibility and quality. The extracted data on concussions were pooled in a meta-analysis using an inverse-variance fixed-effects model. The extracted data on head injuries were reported in a narrative and tabular summary. RESULTS The search yielded 7673 results of which 70 articles were included in the qualitative and 47 in the quantitative analysis. In our meta-analysis, we found the highest concussion incidences in rugby match play (3.89 and 3.00 concussions per 1000 h and athletic exposures (AEs), respectively), and the lowest in men's football training (0.01 and 0.08 per 1000 h and AEs, respectively). Overall, concussions and all head injuries were rare in training when compared to match play. Female players had an increased concussion risk in football and ice hockey when compared to male players. CONCLUSION Future research should focus on concussion in women's contact sports, as there is little evidence available in this area. Methodological deficits are frequent in the current literature, especially regarding sample size and study power, and should be avoided.
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Viviers PL, Viljoen JT, Derman W. A Review of a Decade of Rugby Union Injury Epidemiology: 2007-2017. Sports Health 2018; 10:223-227. [PMID: 29442612 PMCID: PMC5958454 DOI: 10.1177/1941738118757178] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Context: Rugby union is the most widely played team collision sport globally. As with
other contact sports, there is substantial risk of injury. To date, the
majority of studies on injury epidemiology have focused on elite male
cohorts, which inherently prevents extrapolation of research findings to
other groups within the player continuum. This review aims to describe
emerging injury trends across the spectrum of various rugby union
subpopulations and to highlight gaps that may influence future injury
prevention tactics. Evidence Acquisition: Relevant articles published from 2007 to 2017 were obtained by searching
MEDLINE, PubMed, and SPORT Discus. Studies on 15-a-side rugby union,
implemented according to the 2007 consensus statement on injury definitions
and data collection procedures for injuries in rugby union, were used. Study Design: Clinical review. Level of Evidence: Level 3. Results: Match injuries occur more frequently than training injuries. Injury rates
increase consistently according to age and level of play. Severity of injury
often is greater among lower levels of the game, and sex-specific
differences relating to injury patterns and incidence rates exist. Conclusion: To date, a paucity of injury surveillance data exists for women and players
of both sexes at all levels of community rugby union. Furthermore, the
incidence of injuries and illnesses are poorly reported in epidemiological
studies. Despite methodological differences, injury trends remain consistent
throughout all levels of play.
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Affiliation(s)
- Pierre L Viviers
- Institute of Sport and Exercise Medicine, Division of Orthopedics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Campus Health Service, Stellenbosch University, Stellenbosch, South Africa
| | - Jeandré T Viljoen
- Institute of Sport and Exercise Medicine, Division of Orthopedics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Campus Health Service, Stellenbosch University, Stellenbosch, South Africa
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Division of Orthopedics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,IOC Research Centre, Cape Town, South Africa
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17
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Ma R, Lopez V, Weinstein MG, Chen JL, Black CM, Gupta AT, Harbst JD, Victoria C, Allen AA. Injury Profile of American Women's Rugby-7s. Med Sci Sports Exerc 2017; 48:1957-66. [PMID: 27232243 DOI: 10.1249/mss.0000000000000997] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The objective of this study is to determine incidence (injuries/1000 playing hours (ph)), severity (days of absence), and cause of match injuries in US women's Rugby-7s. METHODS We performed a prospective epidemiological study (2010-2013) of injury of 3876 under-19 to elite/national female Rugby-7s players (nonelite = 3324, elite = 552) on 323 teams (nonelite = 277, elite = 46), applying methodology and injury definitions compliant with the international consensus statement on rugby research. Injuries occurred in USA Rugby-sanctioned tournament series: USA Rugby Local Area (2010), Territorial Union (2011-2013), National and All-Star Sevens Series, and USA Sevens Invitational (2011-2012) and Collegiate Rugby Championships (2012). RESULTS One hundred and twenty time-loss injuries were encountered (elite, n = 15; 13%) with an injury rate of 46.3 injuries/1000 ph. Injury rates in nonelite were 49.3/1000 ph, and in national level (elite) candidates, 32.6/1000 ph (RR = 1.5, P = 0.130). Mean days missed found elite level players at 74.9 d per injury, whereas nonelite at 41.8 d (P = 0.090). Acute injuries were significant (95%, RR = 1.9, P < 0.001), resulting in immediate removal from the pitch (56%, P < 0.001). The main mechanism of injury occurred when tackling players (73%, P < 0.001). The most common type of injury seen were ligament sprains (37%, 13.9/1000 ph), involving the lower extremity (45%, 20.5/1000 ph). The most common body parts injured were the knee and head/face (16%, 7.3/1000 ph). CONCLUSIONS Time-loss injuries occurred with frequency in the US women's Rugby-7s tournaments. Overall injury rates in US women are lower than those in international elite men and women's Rugby-7s. The head and neck area in our female players was injured at greater rates (16%) than in international male Rugby-7s (5%). Injury prevention in US women's Rugby-7s must focus on injuries of the knee, head, and neck. Understanding risk factors will allow safe return-to-play decisions and formulate injury prevention protocols.
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Affiliation(s)
- Richard Ma
- 1Missouri Orthopaedic Institute and Comparative Orthopaedic Laboratory, University of Missouri, Columbia, MO; 2Rugby Research and Injury Prevention Group, New York, NY; 3USA Rugby Empire Geographic Union RFU, New York, NY; 4Sports Performance Research Institute New Zealand, Rugby Codes Research Group, Auckland University of Technology, Auckland, NEW ZEALAND; 5Northeast Rugby Academy, USOC-Community Olympic Development Program, New York, NY; 6Steinhardt School of Culture, Education and Human Development, New York University, New York, NY; 7Department of Orthopedics and Sports Medicine, University of California, San Francisco, CA; 8Department of Medical Physiatry, Alberta Health Services, Calgary, Alberta, CANADA; 9Professional Orthopaedic and Sports Physical Therapy, New York, NY; 10Global Institute of Public Health, New York University, New York, NY; 11Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY; 12New York Knickerbockers, National Basketball Association, New York, NY; and 13USA Basketball, Colorado Springs, CO
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18
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Hutton MJ, McGuire RA, Dunn R, Williams R, Robertson P, Twaddle B, Kiely P, Clarke A, Mazda K, Davies P, Pagarigan KT, Dettori JR. Catastrophic Cervical Spine Injuries in Contact Sports. Global Spine J 2016; 6:721-734. [PMID: 27781193 PMCID: PMC5077713 DOI: 10.1055/s-0036-1586744] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 06/21/2016] [Indexed: 11/24/2022] Open
Abstract
Study Design Systematic review. Objectives To determine the incidence of catastrophic cervical spine injuries (CCSIs) among elite athletes participating in contact team sports and whether the incidence varies depending on the use of protective gear or by player position. Methods Electronic databases and reference lists of key articles published from January 1, 2000, to January 29, 2016, were searched. Results Fourteen studies were included that reported CCSI in rugby (n = 10), American football (n = 3), and Irish hurling (n = 1). Among Rugby Union players, incidence of CCSI was 4.1 per 100,000 player-hours. Among National Football League players, the CCSI rate was 0.6 per 100,000 player-exposures. At the collegiate level, the CCSI rate ranged from 1.1 to 4.7 per 100,000 player-years. Mixed populations of elite and recreational rugby players in four studies report a CCSI rate of 1.4 to 7.2 per 100,000 player-years. In this same population, the scrum accounted for 30 to 51% of total reported CCSIs in Rugby Union versus 0 to 4% in Rugby League. The tackle accounted for 29 to 39% of injuries in Rugby Union and 78 to 100% of injuries in Rugby League. Making a tackle was responsible for 29 to 80% of injuries in American football. Conclusion CCSIs are infrequent among elite athletes. There is insufficient evidence to determine the effect of protective gear (e.g., helmets, padding) on CCSI incidence. Scrum and tackle in rugby and tackling in American football account for the majority of CCSIs in each respective sport.
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Affiliation(s)
- Michael James Hutton
- Department of Spine Surgery, Princess Elisabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, Devon, United Kingdom,Address for correspondence Michael James Hutton, FRCS (Trauma & Orth.) Department of Spine Surgery, Princess Elisabeth Orthopaedic CentreRoyal Devon and Exeter Hospital, Barrack Road, Exeter, DevonUnited Kingdom
| | - Robert A. McGuire
- Department of Orthopedics, University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, South Africa
| | - Richard Williams
- Department of Orthopaedics, Queensland University, Brisbane, Australia
| | - Peter Robertson
- Department of Orthopaedics, Auckland City Hospital, Grafton, Auckland, New Zealand
| | - Bruce Twaddle
- Department of Orthopaedic Trauma, Auckland City Hospital, Grafton, Auckland, New Zealand
| | | | - Andrew Clarke
- Department of Orthopaedics, Middlemore Hospital, Auckland, New Zealand
| | - Keyvan Mazda
- Pediatric Orthopaedic Department, Robert Debré Hospital, Paris, France
| | - Paul Davies
- Department of Trauma and Orthopaedics, University Hospital of Wales, Cardiff, United Kingdom
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19
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Swaminathan R, Williams JM, Jones MD, Theobald PS. Does the new rugby union scrum sequence positively influence the hooker's in situ spinal kinematics? BMJ Open Sport Exerc Med 2016; 2:e000064. [PMID: 27900153 PMCID: PMC5117027 DOI: 10.1136/bmjsem-2015-000064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 11/30/2022] Open
Abstract
Background Scrummaging is unique to rugby union and involves 2 ‘packs’ of 8 players competing to regain ball possession. Intending to serve as a quick and safe method to restart the game, injury prevalence during scrummaging necessitates further evaluation of this environment. Aims The aim of this study was to determine the effect of scrummage engagement sequences on spinal kinematics of the hooker. The conditions investigated were: (1) live competitive scrummaging using the new ‘crouch, bind, set’ sequence; (2) live competitive scrummaging using the old ‘crouch touch pause engage’ sequence and (3) training scrummaging using a scrum machine. Methods Inertial sensors provided three-dimensional kinematic data across 5 spinal regions. Participants (n=29) were adult, male community club and university-level hookers. Results Engagement sequence had no effect on resultant kinematics of any spinal region. Machine scrummaging resulted in lesser magnitudes of motion in the upper spinal regions. Around two-thirds of the total available cervical motion was utilised during live scrummaging. Conclusions This study indicates that the most recent laws do not influence the spinal kinematics of the hooker during live scrummaging; however, there may be other benefits from these law changes that fall outside the scope of this investigation.
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Affiliation(s)
- Ramesh Swaminathan
- Bioengineering Research Group , School of Engineering, Cardiff University , Cardiff, South Glamorgan , UK
| | - Jonathan M Williams
- Faculty of Health and Social Sciences , Bournemouth University , Bournemouth, Dorset , UK
| | - Michael D Jones
- Bioengineering Research Group , School of Engineering, Cardiff University , Cardiff, South Glamorgan , UK
| | - Peter S Theobald
- Bioengineering Research Group , School of Engineering, Cardiff University , Cardiff, South Glamorgan , UK
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20
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Lopez V, Ma R, Weinstein MG, Cantu RC, Myers LSD, Nadkar NS, Victoria C, Allen AA. Concussive Injuries in Rugby 7s: An American Experience and Current Review. Med Sci Sports Exerc 2016; 48:1320-30. [PMID: 26829001 DOI: 10.1249/mss.0000000000000892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE There is a comparative lack of concussion incidence data on the new Olympic sport Rugby 7s. This study aimed to determine the incidence (number of concussions per 1000 playing hours [ph]), mean and median severity (days absence), and cause of concussive injuries. METHODS This is a prospective epidemiology study, amateur to elite/national candidate, male (9768) and female (3876) players in USA Rugby sanctioned tournaments, compliant with the international consensus statement for studies in rugby union. RESULTS Concussions in US Rugby 7s were 7.7/1000 ph (n = 67). Women encountered concussions at 8.1/1000 ph, and men at 7.6/1000 ph (risk ratio [RR] = 1.10, P = 0.593). Elite/national-level players encountered concussions at higher rates (18.3/1000 ph) than lower levels (6.4/1000 ph; RR = 5.48, P < 0.001). Nonelite backs had higher concussive injury rates compared with forwards (7.7/1000 ph; 3.6/1000 ph; RR = 1.28, P = 0.024). Women missed 36.7 d absence from play, meanwhile men missed 27.9 d (P = 0.245). Retrospective history recall reflected previous concussive injuries occurred in 43% of the current study's cohort; of these, 57% encountered multiple concussions within 1 yr. The incidence of repetitive concussions was not statistically different between genders (RR = 1.09, P = 0.754). Most concussions occurred from tackles (63%) and collisions (24%) (P = 0.056). CONCLUSIONS Sports-related concussions occurred with frequency among US amateur Rugby 7s players. US Elite tournament players sustained concussions at much higher rates than international male Rugby 7s counterparts. A substantial portion of US players who sustained a concussion had previous concussion injuries. Given the high rate of concussion, including repetitive concussive injuries, US Rugby 7s may benefit from concussion prevention measures similar to other contact sports such as instruction on proper tackling techniques, in-game and postgame medical assessment, and a standardized return-to-play protocol.
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Affiliation(s)
- Victor Lopez
- 1Rugby Research and Injury Prevention Group, New York, NY; 2USA Rugby Empire Geographic Union RFU, New York, NY; 3Rugby Codes Research Group, Sports Performance Research Institute, Auckland University of Technology, Auckland, NEW ZEALAND; 4Northeast Rugby Academy, USOC-Sanctioned Olympic Development Program, New York, NY; 5Comparative Orthopaedic Laboratory, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO; 6Steinhardt School of Culture, Education and Human Development, New York University, New York, NY; 7Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA; 8Department of Neurosurgery, Boston University School of Medicine, Boston, MA; 9Department of Neurosurgery, Emerson Hospital, Concord, MA; 10Department of Surgery, Emerson Hospital, Concord, MA; 11Service of Sports Medicine, Emerson Hospital, Concord, MA; 12Neurologic Sports Injury Center, Brigham and Women's Hospital, Boston, MA; 13Concussion Legacy Foundation, Waltham, MA; 14World Rugby, Independent Concussion Group, Dublin, Ireland; 15Advanced Therapeutics Physical Therapy, Inc., Florence, MA; 16Department of Physical Therapy, Seton Hall University, South Orange Village, NJ; 17New York University, Global Institute of Public Health, New York, NY; 18Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY; 19National Basketball Association, New York Knickerbockers New York, NY; and 20USA Basketball, Colorado Springs, CO
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21
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Swaminathan R, Williams JM, Jones MD, Theobald PS. A kinematic analysis of the spine during rugby scrummaging on natural and synthetic turfs. J Sports Sci 2015; 34:1058-66. [PMID: 26375051 PMCID: PMC4784542 DOI: 10.1080/02640414.2015.1088165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Artificial surfaces are now an established alternative to grass (natural) surfaces in rugby union. Little is known, however, about their potential to reduce injury. This study characterises the spinal kinematics of rugby union hookers during scrummaging on third-generation synthetic (3G) and natural pitches. The spine was sectioned into five segments, with inertial sensors providing three-dimensional kinematic data sampled at 40 Hz/sensor. Twenty-two adult, male community club and university-level hookers were recruited. An equal number were analysed whilst scrummaging on natural or synthetic turf. Players scrummaging on synthetic turf demonstrated less angular velocity in the lower thoracic spine for right and left lateral bending and right rotation. The general reduction in the range of motion and velocities, extrapolated over a prolonged playing career, may mean that the synthetic turf could result in fewer degenerative injuries. It should be noted, however, that this conclusion considers only the scrummaging scenario.
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Affiliation(s)
- Ramesh Swaminathan
- a Bioengineering Research Group, School of Engineering , Cardiff University , Cardiff , UK
| | - Jonathan M Williams
- b Faculty of Health and Social Sciences , Bournemouth University , Bournemouth , UK
| | - Michael D Jones
- a Bioengineering Research Group, School of Engineering , Cardiff University , Cardiff , UK
| | - Peter S Theobald
- a Bioengineering Research Group, School of Engineering , Cardiff University , Cardiff , UK
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Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P. A systematic review and meta-analysis of concussion in rugby union. Sports Med 2015; 44:1717-31. [PMID: 25138311 DOI: 10.1007/s40279-014-0233-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Rugby Union, a popular full-contact sport played throughout the world, has one of the highest rates of concussion of all full-contact sports. OBJECTIVE The aim of the current review was to systematically evaluate the available evidence on concussion in Rugby Union and to conduct a meta-analysis of findings regarding the incidence of concussion. METHODS Articles were retrieved via a number of online databases. The current review examined all articles published in English up to May 2014 pertaining to concussion in Rugby Union players. The key search terms included 'Rugby Union', 'rugby', 'union', and 'football', in combination with the injury terms 'athletic injuries', 'concussion', 'sports concussion', 'sports-related concussion', 'brain concussion', 'brain injury', 'brain injuries', 'mild traumatic brain injury', 'mTBI', 'traumatic brain injury', 'TBI', 'craniocerebral trauma', 'head injury', and 'brain damage'. RESULTS The final search outcome following the eligibility screening process resulted in the inclusion of 96 articles for this review. The meta-analysis included a total of 37 studies. The results of the meta-analysis revealed an overall incidence of match-play concussion in men's rugby-15s of 4.73 per 1,000 player match hours. The incidence of concussion during training was 0.07 per 1,000 practice hours. The incidence of concussion in women's rugby-15s was 0.55 per 1,000 player match hours. In men's rugby-7s match-play, concussion incidence was 3.01 per 1,000 player match hours. The incidence of concussion varied considerably between levels of play, with elite level play recording a rate of 0.40 concussions per 1,000 player match hours, schoolboy level 0.62 concussions per 1,000 player match hours, and the community or sub-elite level recording a rate of 2.08 concussions per 1,000 player match hours. The incidence of concussion in men's rugby-15s as a function of playing position (forwards vs. backs) was 4.02 and 4.85 concussions per 1,000 player match hours, respectively. CONCLUSIONS Concussion is a common injury sustained and reported in match play and to a lesser extent during practice by Rugby Union players. Based on the available published data, there appears to be a variation in risk of concussion across level of play, with the sub-elite level having the greatest incidence of injury. Future research focused on studying the acute consequences and best management strategies in current players, and the potential longer term outcomes of concussion in retired players, is needed. A focus on the areas of prevention, injury identification, and medical management, and risk for long-term outcomes will be of benefit to current athletes.
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Affiliation(s)
- Andrew J Gardner
- Centre for Translational Neuroscience and Mental Health, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia,
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Nicolini AP, Carvalho RTD, Matsuda MM, Sayum Filho J, Cohen M. Common injuries in athletes' knee: experience of a specialized center. ACTA ORTOPEDICA BRASILEIRA 2014; 22:127-31. [PMID: 25061417 PMCID: PMC4108693 DOI: 10.1590/1413-78522014220300475] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 01/11/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE: The present cross-sectional study aims to identify the most common knee injuries in athletes cared at a Specialized Outpatient Clinics. METHOD: Analysis of patients cared at the Knee Outpatient Clinics of a Sports Trauma Center, divided by gender, age and diagnosed injury. RESULTS: Initially 440 patients were divided into 33 types of sports; after excluding the less statistically significant practices, nine sports remained. The most frequently performed sports were football with almost 50% of total patients presenting anterior cruciate ligament (ACL) injury, and road runs with great frequency of meniscal injury. There was no correlation of the disorder with the type of sports performed but a correlation was found with patient's age/gender. CONCLUSION: The complete ACL rupture was the most common injury found in football, basketball and volleyball players, followed by meniscal injury in street runners. Level of Evidence IV, Study Transversal.
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Affiliation(s)
| | | | | | | | - Moisés Cohen
- Universidade Federal de São Paulo (Unifesp), Brazil
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Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 2014; 44:123-40. [PMID: 24105612 DOI: 10.1007/s40279-013-0102-5] [Citation(s) in RCA: 477] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. OBJECTIVE Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. METHODS We conducted a systematic review and meta-analyses of English articles using relevant computerised databases. Search terms included Medical Search Headings for the ankle joint, injury and epidemiology. The following inclusion criteria were used: the study must report epidemiology findings of injuries sustained in an observed sample; the study must report ankle sprain injury with either incidence rate or prevalence period among the surveyed sample, or provide sufficient data from which these figures could be calculated; the study design must be prospective. Independent extraction of articles was performed by two authors using pre-determined data fields. RESULTS One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. The average rating of all the included studies was 6.67/11, based on an adapted version of the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines for rating observational studies. 116 studies were considered high quality and 65 were considered low quality. The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. Low-quality studies tended to underestimate the incidence of ankle sprain when compared with high-quality studies (0.54 vs 11.55 per 1,000 exposures). Ankle sprain prevalence period estimates were similar across sub-groups. Lateral ankle sprain was the most commonly observed type of ankle sprain. CONCLUSIONS Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.
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Affiliation(s)
- Cailbhe Doherty
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland,
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25
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Trewartha G, Preatoni E, England ME, Stokes KA. Injury and biomechanical perspectives on the rugby scrum: a review of the literature. Br J Sports Med 2014; 49:425-33. [PMID: 24398223 DOI: 10.1136/bjsports-2013-092972] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
As a collision sport, rugby union has a relatively high overall injury incidence, with most injuries being associated with contact events. Historically, the set scrum has been a focus of the sports medicine community due to the perceived risk of catastrophic spinal injury during scrummaging. The contemporary rugby union scrum is a highly dynamic activity but to this point has not been well characterised mechanically. In this review, we synthesise the available research literature relating to the medical and biomechanical aspects of the rugby union scrum, in order to (1) review the injury epidemiology of rugby scrummaging; (2) consider the evidence for specific injury mechanisms existing to cause serious scrum injuries and (3) synthesise the information available on the biomechanics of scrummaging, primarily with respect to force production. The review highlights that the incidence of acute injury associated with scrummaging is moderate but the risk per event is high. The review also suggests an emerging acknowledgement of the potential for scrummaging to lead to premature chronic degeneration injuries of the cervical spine and summarises the mechanisms by which these chronic injuries are thought to occur. More recent biomechanical studies of rugby scrummaging confirm that scrum engagement forces are high and multiplanar, but can be altered through modifications to the scrum engagement process which control the engagement velocity. As the set scrum is a relatively 'controlled' contact situation within rugby union, it remains an important area for intervention with a long-term goal of injury reduction.
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Affiliation(s)
- Grant Trewartha
- Department for Health, Sport, Health and Exercise Science, University of Bath, Bath, UK
| | - Ezio Preatoni
- Department for Health, Sport, Health and Exercise Science, University of Bath, Bath, UK
| | - Michael E England
- Department for Health, Sport, Health and Exercise Science, University of Bath, Bath, UK Rugby Football Union, Twickenham, UK
| | - Keith A Stokes
- Department for Health, Sport, Health and Exercise Science, University of Bath, Bath, UK
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26
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Hayashi D, Roemer FW, Kohler R, Guermazi A, Gebers C, De Villiers R. Thoracic injuries in professional rugby players: mechanisms of injury and imaging characteristics. Br J Sports Med 2013; 48:1097-101. [PMID: 23962879 DOI: 10.1136/bjsports-2013-092681] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Professional rugby players are prone to traumatic thoracic injuries due to the use of minimal protective gear to cover the torso. In the 2007 Rugby World Cup, thoracic injuries occurred at a rate of 8.3 cases/1000 player-hours. CT and MRI play an important role in the diagnosis of these injuries. Vital internal organs, such as the heart, lungs, trachea, liver and large blood vessels lie within close proximity to the bony structures and what seems to be a simple rib fracture or clavicular dislocation can have potentially life-threatening complications that are not detected by conventional radiography. Cross-sectional imaging helps to determine the choice of treatment. Ultrasound offers a quick and dynamic imaging examination and allows high-resolution assessment of superficial tissues that complements conventional imaging. In this review article, we (1) presented data on incidence of thoracic injuries in professional rugby players; (2) described the anatomy of the joints comprising the thoracic cage and major muscles attached to the rib cage; (3) discussed indications and relevance for MRI and presented an optimised MRI protocol for assessment of suspected thoracic injury; and (4) illustrated various types of thoracic injuries seen in professional rugby players, including sternal contusion, retrosternal haematoma, manubriosternal disruption, sternoclavicular dislocation, rib fractures and injuries of the pectoralis major muscle.
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Affiliation(s)
- Daichi Hayashi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Radiology, Bridgeport Hospital, Yale University School of Medicine, Bridgeport, Connecticut, USA
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Radiology, University of Erlangen, Erlangen, Germany
| | - Ryan Kohler
- Australian Sports Commission, Bruce, Australia
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Chris Gebers
- Drs Van Wageningen and Partners, Somerset West, South Africa
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27
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Affiliation(s)
- Stefan Schildknecht
- Centre of Dental Traumatology, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, Basel, Switzerland
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Lopez V, Galano GJ, Black CM, Gupta AT, James DE, Kelleher KM, Allen AA. Profile of an American amateur rugby union sevens series. Am J Sports Med 2012; 40:179-84. [PMID: 22102102 DOI: 10.1177/0363546511427124] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rugby union will enter the Olympic arena as Rugby Sevens in 2016. PURPOSE To investigate the injury rate, injury type, and nature of injuries sustained in an amateur American rugby union sevens tournament series. STUDY DESIGN Descriptive epidemiology study. METHODS The rate, demographics, and characteristics of injury were evaluated in 1536 rugby union sevens players, from 128 sides, competing in 4 amateur 1-day tournaments in a USA Rugby local area rugby union. RESULTS Forty-eight injuries occurred over 4 tournaments, for an injury rate of 55.4 injuries per 1000 playing hours. Head and neck injuries were most common (33.3% of injuries), followed by upper extremity (31.3%), trunk (18.8%), lower extremity (14.6%), and physiologic injuries (2.1%). The most common type of injury was ligament sprain (25.0%); followed by concussion (14.6%), hematoma/contusion (12.5%), muscle strain (10.4%), and abrasion (8.3%). Tackling was the most common mechanism of injury (74.5%). Males were injured at a significantly higher rate than females (RR, 7.5, P < .01), but no significant difference was observed based on player position (P = .08). CONCLUSION Injuries are common among American amateur rugby athletes, with a substantial proportion involving the head and neck region. CLINICAL RELEVANCE Understanding injury patterns in an American rugby union will be important for formulating future injury prevention, assessment, and treatment protocols.
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Affiliation(s)
- Victor Lopez
- Rugby Research and Injury Prevention Group, New York, New York, USA
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Cusimano MD, Nassiri F, Chang Y. The effectiveness of interventions to reduce neurological injuries in rugby union: a systematic review. Neurosurgery 2011; 67:1404-18; discussion 1418. [PMID: 20871440 DOI: 10.1227/neu.0b013e3181f209f1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Rugby is characterized by high-speed collisions among the players that predispose them to injuries, particularly to the head, neck, and spine. OBJECTIVE To evaluate the effectiveness of current neurological injury prevention strategies in rugby union. METHODS Systematic review in May 2010. We assessed the quality and content of studies that evaluated injury prevention strategies for rugby players and reported on neurological outcomes. We searched OVID Medline, OVID HealthStar, CINAHL, Sport Discus, PubMed, Scholar's Portal Physical Education Index, Web of Science, and the Cochrane Controlled Clinical Trials Register (CENTRAL) and conducted a manual search of the cited literature lists of each included study. RESULTS Ten articles are included in the review, with 2 of these assessing both headgear and mouthguards. Four studies reported insignificant reductions in neurological injury with the use of headgear. The results of 4 studies on the effectiveness of mouthguards in preventing neurological injury were inconclusive. Four studies reported significant reductions in neurological injury after the implementation of nationwide multifaceted injury prevention strategies with a focus on education CONCLUSION There is limited evidence to support the effectiveness of mouthguards and headgear in reducing neurological injuries; however, system-wide, mandatory interventions are useful in reducing neurological injuries in rugby.
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Affiliation(s)
- Michael D Cusimano
- Division of Neurosurgery, St. Michael's Hospital, and Injury Prevention Research Office, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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Incidence and severity of neck injury in Rugby Union: a systematic review. J Sci Med Sport 2010; 14:383-9. [PMID: 21169056 DOI: 10.1016/j.jsams.2010.10.460] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 10/19/2010] [Accepted: 10/23/2010] [Indexed: 11/22/2022]
Abstract
Objectives. To collate and appraise incidence and severity data for neck injury in Rugby Union. To report risk factors for neck injury in Rugby Union that are supported by incidence and severity data. Design. Systematic review. Methods. Original journal articles were retrieved from electronic searches of AusportMed, AUSPORT, Scopus, Medline (Ovid), CINAHL, Mantis, and Pubmed databases and relevant bibliographic hand searches. Selection criteria were restricted to: (a) prospective study designs including cohort, case-control, and intervention methodologies; (b) populations of Rugby Union players, either male or female of any age; (c) studies must report on neck injury incidence and/or severity specifically; (d) articles with republished neck injury data were excluded. The STROBE Statement was adapted for the quality assessment of included studies and categorised as either poor, moderate or good. Results. Thirty-three original articles met the selection criteria. Wide variation of injury and exposure definitions and population sampling was identified in the included articles. Neck injury incidence ranged between 0.26 (CI: 0.08, 0.93) and 9.17 (CI: 1.89, 26.81) per 1000 player hours for mixed populations that adopted an all inclusive sports injury definition. There is a paucity of severity data and analytical data which evaluates causal roles of risk factors for neck injury in Rugby Union. Conclusions. Meaningful understanding of neck injury incidence and severity in Rugby Union is restricted to a few studies which adopt comparable methodological construct. This paper provides an index for future neck injury studies in Rugby Union.
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