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Palmer D, Soligard T, Fernandes G, Collins D, Elliott N, Kelly P, Murray I, Engbretsen L. IOC Olympian Health Cohort: a study protocol for a 15-year, prospective, Olympian health study across Summer and Winter Olympic sports. BMJ Open Sport Exerc Med 2024; 10:e002061. [PMID: 38859820 PMCID: PMC11163683 DOI: 10.1136/bmjsem-2024-002061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2024] [Indexed: 06/12/2024] Open
Abstract
Prevention of sports injury and illness and protection of athlete health are key mandates of the IOC. Methodological limitations in Olympic Games surveillance and retired Olympian studies mean there are gaps in the available evidence on Olympian health and the varied challenges occurring at different stages throughout an athlete's career. This (protocol) paper describes the methods for implementation of the IOC Olympian Health Cohort. The study aims to establish a longitudinal cohort of current Olympians and follow them prospectively (around 15 years) throughout their Olympic careers and retirement. The study will use participants who have completed self-report questionnaires. Olympians will be recruited after each Summer and Winter Olympic Games, and all National Olympic Committee (NOC) athletes aged 16 years or older are eligible. The first phase included the Tokyo 2020/2021 and Beijing 2022 Olympians, with the study promoted via IOC platforms, Athlete365 and NOCs. Questionnaires include baseline demographics, sports exposure and history of injuries and illnesses impacting the athlete's ability to continue to train and/or compete for at least 2 weeks. Questions also address retirement from sports, musculoskeletal, mental and general health, and quality of life measures. This protocol describes the methods for the 15-year global IOC Olympian Health Cohort Study, from participant recruitment to the development and distribution of the study questionnaire. This protocol will be updated to report future changes in the study's conduct or questionnaire content. These data will help identify risk factors and inform risk-reduction strategies. The ultimate goal is to protect the health of all athletes during their careers and retirement.
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Affiliation(s)
- Debbie Palmer
- Edinburgh Sports Medicine Research Network, Institute for Sport, PE and Health Sciences, The University of Edinburgh, Edinburgh, UK
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), The University of Edinburgh, Edinburgh, UK
| | | | - Gwen Fernandes
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Dave Collins
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), The University of Edinburgh, Edinburgh, UK
- Grey Matters Performance, London, UK
| | - Niall Elliott
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), The University of Edinburgh, Edinburgh, UK
- Sports & Exercise Medicine, Sportscotland Institute of Sport, Stirling, UK
| | - Paul Kelly
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), The University of Edinburgh, Edinburgh, UK
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Iain Murray
- UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), The University of Edinburgh, Edinburgh, UK
- Edinburgh Sports Medicine Research Network, Institute for Sport, PE and Health Sciences, Edinburgh Orthopaedics, Edinburgh, UK
| | - Lars Engbretsen
- IOC Medical and Scientific Commission, Lausanne, Switzerland
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Palau M, Baiget E, Cortés J, Martínez J, Crespo M, Casals M. Retirements of professional tennis players in second- and third-tier tournaments on the ATP and WTA tours. PLoS One 2024; 19:e0304638. [PMID: 38829827 PMCID: PMC11146734 DOI: 10.1371/journal.pone.0304638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024] Open
Abstract
The demands of professional tennis, including physical and psychological aspects, contribute to the frequency of retirements at elite levels of the sport. The aim of this study was to analyze epidemiological patterns and risk factors associated with retirements in previous ATP and WTA Tour tournaments. A retrospective cohort study was conducted. This study focused on previous ATP and WTA Tour tournaments. The ATP database encompassed 584,806 matches, while the WTA database included 267,380 matches. To assess retirements, potential risk factors such as playing surface, tournament category, match round, and player age were analyzed. Incidence rates were calculated for the period between 1978-2019 for men and 1994-2018 for women. The overall incidence rate was 1.56 (95%CI: 1.54, 1.59) and 1.36 (95%CI: 1.33, 1.39) retirements per 1000 games played in male and female competitions, respectively. Retirements increased over the years. Higher incidence rates were observed on hard (1.59 [95%CI: 1.56, 1.63] and 1.39 [95%CI: 1.34, 1.44]) and clay (1.60 [95%CI: 1.57, 1.63] and 1.36 [95%CI: 1.32, 1.41]) compared to grass courts (0.79 [95%CI: 0.65, 0.94] and 1.06 [95%CI: 0.88, 1.27]). Risk factors differed by gender, with tournament category significant in males (IRR: 1.23 [95%CI: 1.19, 1.28] in ITF vs ATP) and match round in females (IRR: 0.92 [95%CI: 0.88, 0.98] in preliminary vs final). This study provides valuable insights for coaches, players, support teams, and epidemiologists regarding retirements and associated risk factors in previous ATP and WTA Tour tournaments, contributing to injury prevention strategies.
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Affiliation(s)
- Maria Palau
- Universitat Oberta de Catalunya, Barcelona, Spain
| | - Ernest Baiget
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona, Barcelona, Spain
| | - Jordi Cortés
- Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Joan Martínez
- Girona Biomedical Research Institute-IDIBGI, Salt, Spain
| | - Miguel Crespo
- Development Department, International Tennis Federation, London, United Kingdom
| | - Martí Casals
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona, Barcelona, Spain
- Sport and Physical Activity Studies Centre (CEEAF), Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
- Sport Performance Analysis Research Group, University of Vic-Central University of Catalonia (UVic-UCC), Barcelona, Spain
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Tooby J, Woodward J, Tucker R, Jones B, Falvey É, Salmon D, Bussey MD, Starling L, Tierney G. Instrumented Mouthguards in Elite-Level Men's and Women's Rugby Union: The Incidence and Propensity of Head Acceleration Events in Matches. Sports Med 2024; 54:1327-1338. [PMID: 37906425 PMCID: PMC11127838 DOI: 10.1007/s40279-023-01953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine head acceleration event (HAE) propensity and incidence during elite-level men's and women's rugby union matches. METHODS Instrumented mouthguards (iMGs) were fitted in 92 male and 72 female players from nine elite-level clubs and three international teams. Data were collected during 406 player matches (239 male, 167 female) using iMGs and video analysis. Incidence was calculated as the number of HAEs per player hour and propensity as the proportion of contact events resulting in an HAE at a range of linear and angular thresholds. RESULTS HAE incidence above 10 g was 22.7 and 13.2 per hour in men's forwards and backs and 11.8 and 7.2 per hour in women's forwards and backs, respectively. Propensity varied by contact event, with 35.6% and 35.4% of men's tackles and carries and 23.1% and 19.6% of women's tackles and carries producing HAEs above 1.0 krad/s2. Tackles produced significantly more HAEs than carries, and incidence was greater in forwards compared with backs for both sexes and in men compared with women. Women's forwards were 1.6 times more likely to experience a medium-magnitude HAE from a carry than women's backs. Propensity was similar from tackles and carries, and between positional groups, while significantly higher in men than women. The initial collision stage of the tackle had a higher propensity than other stages. CONCLUSION This study quantifies HAE exposures in elite rugby union players using iMGs. Most contact events in rugby union resulted in lower-magnitude HAEs, while higher-magnitude HAEs were comparatively rare. An HAE above 40 g occurred once every 60-100 min in men and 200-300 min in women. Future research on mechanisms for HAEs may inform strategies aimed at reducing HAEs.
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Affiliation(s)
- James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - James Woodward
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Ross Tucker
- Department of Sport Science, Institute of Sport and Exercise Medicine, University of Stellenbosch, Stellenbosch, South Africa
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Division of Physiological Sciences and Health Through Physical Activity, Department of Human Biology, Faculty of Health Sciences, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
- England Performance Unit, Rugby Football League, Manchester, UK
- Premiership Rugby, London, UK
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Éanna Falvey
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
- School of Medicine & Health, University College Cork, Cork, Ireland
| | - Danielle Salmon
- World Rugby, 8-10 Pembroke St., Dublin, Ireland
- New Zealand Rugby, Auckland, New Zealand
| | - Melanie Dawn Bussey
- School of Physical Education Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | | | - Gregory Tierney
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK.
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Hohmann E, Bloomfield P, Dvorak J, Echemendia R, Frank RM, Ganda J, Gordon L, Holtzhausen L, Kourie A, Mampane J, Makdissi M, Patricios J, Pieroth E, Putukian M, Janse van Rensburg DC, Viviers P, Williams V, de Wilde J. On-Field and Pitch-Side (Sideline) Assessment of Sports Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique. Arthroscopy 2024; 40:449-459.e4. [PMID: 37391103 DOI: 10.1016/j.arthro.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE To perform a Delphi consensus for on-field and pitch-side assessment of sports-related concussion (SRC). METHODS Open-ended questions in rounds 1 and 2 were answered. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3. If agreement at round 3 was ≤80% for an item, if panel members were outside consensus, or there were >30% neither agree/disagree responses, the results were carried forward into round 4. The level of agreement and consensus was defined as 90%. RESULTS Loss of consciousness (LOC) or suspected LOC, motor incoordination/ataxia, balance disturbance, confusion/disorientation, memory disturbance/amnesia, blurred vision/light sensitivity, irritability, slurred speech, slow reaction time, lying motionless, dizziness, headaches/pressure in the head, falling to the ground with no protective action, slow to get up after a hit, dazed look, and posturing/seizures were clinical signs of SRC and indicate removal from play. Video assessment is helpful but should not replace clinical judgment. LOC/unresponsiveness, signs of cervical spine injury, suspicion of other fractures (skull/maxillo-facial), seizures, Glasgow Coma Scale score <14 and abnormal neurologic examination findings are indications for hospitalization. Return to play should only be considered when no clinical signs of SRC are present. Every suspected concussion should be referred to an experienced physician. CONCLUSIONS Consensus was achieved for 85% of the clinical signs indicating concussion. On-field and pitch-side assessment should include the observation of the mechanism, a clinical examination, and cervical spine assessment. Of the 19 signs and red flags requiring removal from play, consensus was reached for 74%. Normal clinical examination and HIA with no signs of concussion allow return to play. Video assessment should be mandatory for professional games but should not replace clinical decision-making. Sports Concussion Assessment Tool, Glasgow Coma Scale, vestibular/ocular motor screening, Head Injury Assessment Criteria 1, and Maddocks questions are useful tools. Guidelines are helpful for non-health professionals. LEVEL OF EVIDENCE Level V, expert opinion.
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Affiliation(s)
- Erik Hohmann
- Medical School, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Department of Orthopaedic Surgery and Sports Medicine, Burjeel Hospital for Advanced Surgery, Dubai, United Arab Emirates.
| | - Paul Bloomfield
- CMO Manly Sea Eagles, NRL Team; World Rugby Concussion Consultant; Former CMO National Rugby League, Sydney, Australia
| | - Jiri Dvorak
- Department of Neurology, Spine Unit, Schulthess Clinic, Zurich, Switzerland; Former CMO FIFA
| | - Ruben Echemendia
- Psychological & Neurobehavioral Associates, State College, Pennsylvania, U.S.A.; Department of Psychology, University of Missouri, Kansas City, Missouri, U.S.A.; Co-Chair NHL/NHLPA Concussion Subcommittee; Chair Major League Soccer Concussion Committee
| | - Rachel M Frank
- Department of Orthopaedic Surgery, University of Colorado Medical School, Aurora, Colorado, U.S.A.; Head Team Orthopaedic Surgeon Colorado Rapids, Team Physician University of Colorado Buffaloes, U.S. Soccer Network Physician
| | - Janesh Ganda
- Sports Rehab Centre, Cape Town, South Africa; Team Physician SA 7's Rugby Team; Medical Officer South African Sports Association and Olympic Committee
| | - Leigh Gordon
- Cape Sports Med Clinic, Cape Town, South Africa; Department of Sports & Exercise Medicine, Cape Town South Africa; World Rugby Concussion Consultant, Team Physician Rugby 7s, MO International Hockey Federation; Former Team Physician 7's Rugby
| | - Louis Holtzhausen
- Chief of Sports Medicine, Director Aspetar Sports Related Concussion Program; Orthopaedic and Sports Medicine Hospital, Aspetar, Doha, Qatar; Section Sports Medicine, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa; Department of Exercise and Sports Sciences, University of the Free State, Bloemfontein, South Africa; Former Team Physician South African Olympic Team and Professional Rugby, Cricket and Hockey Teams
| | - Alan Kourie
- Head of Department of Sports Medicine, Mediclinic Parkview; Dubai, United Arab Emirates; CMO Dubai Hurricanes, Former Team Doctor Natal Sharks Rugby
| | - Jerome Mampane
- CMO South African Rugby Team (Springboks); CMO Kaizer Chiefs Football Club; former CMO South African Soccer Team (Bafana Bafana)
| | - Michael Makdissi
- Olympic Park Sports Medicine Centre, Melbourne, Australia; CMO Australian Football League, Melbourne, Australia; La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia; World Rugby Concussion Consultant
| | - Jon Patricios
- Wits Sport and Health (WiSH); School of Clinical Medicine, Faculty of Health Sciences; University of the Witwatersrand, Johannesburg, South Africa; Co-Chair of the 6th International Conference on Concussion in Sports; South African and World Rugby Concussion Consultant; UEFA Head Injury Consultant; FIFA Concussion Consultant
| | - Elizabeth Pieroth
- Department of Orthopaedics, Department of Psychiatry and Behavioral Sciences; Rush Medical College, Chicago, Illinois, U.S.A.; Co-Director NFL Neuropsychology Consultant Program; Director NSW Concussion Program; Concussion Specialist for Chicago Bears, Blackhawks White Socks, Fire, Red Stars, Steel, Rockford IceHogs, Indy Fuel
| | | | - Dina C Janse van Rensburg
- Section Sports Medicine, University of Pretoria, Faculty of Health Sciences, Pretoria South Africa; Medical Advisory Panel, World Netball, Manchester, United Kingdom
| | - Pierre Viviers
- Senior Director Campus Health Service; Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Science, Stellenbosch University, Stellenbosch, South Africa
| | - Vernon Williams
- Center for Sports Neurology & Pain Medicine, Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, U.S.A.; Team Neurologist Los Angeles Rams, LA Dodgers, LA Lakers, LA Clippers, LA Kings, LA Sparks; Vice-Chair California State Athletic Commission, Chair American Academy of Sports Neurology Section
| | - Jean de Wilde
- Musculoskeletal Service Emirates Airline, Dubai, United Arab Emirates; Medical Officer South African Sports Association and Olympic Committee; Former Match Day and Stadium Physician Lions Rugby Team
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Kerin F, O'Flanagan S, Coyle J, Curley D, Farrell G, Persson UM, De Vito G, Delahunt E. Are all hamstring injuries equal? A retrospective analysis of time to return to full training following BAMIC type 'c' and T-junction injuries in professional men's rugby union. Scand J Med Sci Sports 2024; 34:e14586. [PMID: 38375584 DOI: 10.1111/sms.14586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/21/2024]
Abstract
We aimed to determine whether the anatomical location (intramuscular tendon or T-Junction) of hamstring muscle injuries in professional men's rugby union associates with a prolonged time to return to full training and a higher rate of re-injury/subsequent injury. We reviewed the medical records of an Irish professional rugby union club to identify hamstring muscle injuries incurred across five seasons. Clinicians and players were not blinded to MRI results at the time of rehabilitation. A blinded musculoskeletal radiologist re-classified all included injuries (n = 91) according to the British Athletics Muscle Injury Classification framework. Players who sustained an injury with intramuscular tendon involvement required a longer time to return to full training compared to players who sustained an injury without intramuscular tendon involvement (78 days vs. 24 days). Players who sustained a biceps femoris injury with T-junction involvement did not require a longer time to return to full training compared to players who sustained a biceps femoris injury without T-junction involvement (29 days vs. 27 days). Injuries with either intramuscular tendon or T-junction involvement were not associated with an increased rate of re-injury/subsequent injury to the same limb (intramuscular tendon involvement - odds ratio = 0.96, T-junction involvement - odds ratio = 1.03). When a hamstring muscle injury involves the intramuscular tendon, the injured player and stakeholders should be made aware that a longer time to return to full training is likely required. T-junction involvement does not alter the expected clinical course of biceps femoris injuries.
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Affiliation(s)
- Fearghal Kerin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Stuart O'Flanagan
- Leinster Rugby, Dublin, Ireland
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | - Joe Coyle
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | | | | | - Ulrik McCarthy Persson
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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Tierney G, Rowson S, Gellner R, Allan D, Iqbal S, Biglarbeigi P, Tooby J, Woodward J, Payam AF. Head Exposure to Acceleration Database in Sport (HEADSport): a kinematic signal processing method to enable instrumented mouthguard (iMG) field-based inter-study comparisons. BMJ Open Sport Exerc Med 2024; 10:e001758. [PMID: 38304714 PMCID: PMC10831454 DOI: 10.1136/bmjsem-2023-001758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 02/03/2024] Open
Abstract
Objective Instrumented mouthguard (iMG) systems use different signal processing approaches limiting field-based inter-study comparisons, especially when artefacts are present in the signal. The objective of this study was to assess the frequency content and characteristics of head kinematic signals from head impact reconstruction laboratory and field-based environments to develop an artefact attenuation filtering method (HEADSport filter method). Methods Laboratory impacts (n=72) on a test-dummy headform ranging from 25 to 150 g were conducted and 126 rugby union players were equipped with iMGs for 209 player-matches. Power spectral density (PSD) characteristics of the laboratory impacts and on-field head acceleration events (HAEs) (n=5694) such as the 95th percentile cumulative sum PSD frequency were used to develop the HEADSport method. The HEADSport filter method was compared with two other common filtering approaches (Butterworth-200Hz and CFC180 filter) through signal-to-noise ratio (SNR) and mixed linear effects models for laboratory and on-field events, respectively. Results The HEADSport filter method produced marginally higher SNR than the Butterworth-200Hz and CFC180 filter and on-field peak linear acceleration (PLA) and peak angular acceleration (PAA) values within the magnitude range tested in the laboratory. Median PLA and PAA (and outlier values) were higher for the CFC180 filter than the Butterworth-200Hz and HEADSport filter method (p<0.01). Conclusion The HEADSport filter method could enable iMG field-based inter-study comparisons and is openly available at https://github.com/GTBiomech/HEADSport-Filter-Method.
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Affiliation(s)
- Gregory Tierney
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), Ulster University, Belfast, UK
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Steven Rowson
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Ryan Gellner
- Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - David Allan
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), Ulster University, Belfast, UK
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Sadaf Iqbal
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | | | - James Tooby
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - James Woodward
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, UK
| | - Amir Farokh Payam
- Nanotechnology and Integrated Bioengineering Centre (NIBEC), Ulster University, Belfast, UK
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Julien A, Tessier S, Tisserand C, Péran P, Planton M, Pariente J, Brauge D. Effects of sociodemographic and player characteristics on baseline cognitive performance in 1000 rugby players: A retrospective 8-year follow-up study. J Sci Med Sport 2023; 26:676-681. [PMID: 37778958 DOI: 10.1016/j.jsams.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To analyze the effects of sociodemographic and player characteristics on the Sport Concussion Assessment Tool and neuropsychological scores over 8 years in a large sample of rugby players. DESIGN An 8-year retrospective study of preseason clinical assessments of professional rugby players and players enrolled in training academies at professional clubs. METHODS The Sport Concussion Assessment Tool-3 or -5, Trail Making Test and Digit Symbol Substitution Test were administered prior to the start of the competition season for each player. Statistical analyses included: (i) descriptive analyses of sociodemographic, player and neuropsychological characteristics; (ii) multivariate models to identify factors influencing cognitive scores at the first visit; and (iii) linear mixed models to assess the evolution of the scores over the years. RESULTS One thousand players were included (mean age: 22.8, males: 92 %). Twenty-two percent of the athletes reported baseline symptoms. A higher level of education was associated with better cognitive scores at the first visit and over the years. Forwards had poorer processing speed performances compared to backs at the first visit and over repeated assessments. Finally, the number of examinations was associated with improved cognitive scores showing a practice effect on all the neuropsychological tests, except for the Standardized Assessment of Concussion 5th edition. CONCLUSIONS Results from this retrospective study could help to improve the management of athletes and return-to-play decision-making in collision sports.
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Affiliation(s)
- Adeline Julien
- Department of Neurology, Toulouse University Hospital, France; Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, France.
| | - Samuel Tessier
- Department of Neurosciences MéDatAS Unit CIC, Toulouse University Hospital, France
| | | | - Patrice Péran
- Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, France
| | - Mélanie Planton
- Department of Neurology, Toulouse University Hospital, France; Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, France
| | - Jérémie Pariente
- Department of Neurology, Toulouse University Hospital, France; Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, France
| | - David Brauge
- Toulouse Neuroimaging Center, Université de Toulouse, Inserm, UPS, France; University Sports Clinic, Toulouse University Hospital, France; Clinique des Cèdres, Ramsay Santé, France
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8
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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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9
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de Pablo B, Sugimoto D, Arboix-Alio J, Rodas G, Casals M. Analysis of injuries during the 2019 Rink Hockey World Championship. PHYSICIAN SPORTSMED 2023; 51:442-448. [PMID: 36166621 DOI: 10.1080/00913847.2022.2129502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 09/21/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The purpose of this study is to describe the incidence and characteristics of injuries at the 2019 Rink Hockey World Championship. METHODS A cross-sectional study was performed among rink hockey athletes from three National Teams (Argentina, Portugal, and Spain). All injuries were reported by the medical staff of each National Team during the preparation period and the competition in the 2019 World Championship (Barcelona, Spain). Injury rate was calculated as the number of injuries per 1000 hours of player-hours of exposure. RESULTS A total of 91 players (n = 61, 67% male; and n = 30, 33% female) participated in the study: 31 Senior Male (34%), 30 Senior Female (33%), and 30 Under-19 Male (33%). A total of 54 games were played by 9 teams from 3 countries, comprising of 4562 and 4380 hours of total athletic game and training exposure recorded, respectively. Fifty-one injuries (20 injuries with time-loss and 31 medical attention -injuries with no time-loss) were reported. The overall injury incidence rate was 11.2/1000 hours (95% CI, 8.5-14.7). The injury incidence during games (27.5; 95% CI, 11.6-65.2) was higher than the injury incidence during training sessions (3.4; 95% CI, 2-5.7). The incidence rate for game for the entire study period was 8.19 times higher (95% CI, 2.61-21.36) than that for training. The global injury burden was 45.4 days/1000 hours for a total exposure time. Acute was the most frequently documented onset and the non-contact was the most common mechanism. The most frequently reported injuries were head contusion (n = 5, 25%), followed by thigh injuries (n = 3, 15%). CONCLUSIONS The injury incidence reported in a Rink Hockey international competition was 11.2/1000 hours. The risk of injury was higher during games than during training. Prevention strategies for injuries in these kinds of championships may be worth discussing. The craniofacial injuries were the most frequently reported.
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Affiliation(s)
- Bernat de Pablo
- Emergency Department, Hospital Universitari Mutua Terrassa, Barcelona, Spain
- Medical Department, Futbol Club Barcelona, Barça Innovation Hub, Barcelona, Spain
- Doctoral Program in Medicine and Biomedical Sciences, University of Vic - Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Dai Sugimoto
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
- Sports Medicine Unit, The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
| | - Jordi Arboix-Alio
- Department of Sports Science, Ramon Llull University, Fpcee Blanquerna, Barcelona, Spain
| | - Gil Rodas
- Medical Department, Futbol Club Barcelona, Barça Innovation Hub, Barcelona, Spain
- Sports Medicine Unit, Hospital Clinic & Hospital Sant Joan de Déu, Barcelona, Spain
| | - Martí Casals
- Sport and Physical Activity Studies Centre, Faculty of Medicine, Universitat de Vic - Universitat Central de Catalunya, Vic, Catalunya, Spain
- Sport Performance Analysis Research Group (SPARG), University of Vic - Central University of Catalonia, Vic, Barcelona, Spain
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
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10
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Liston M, Leckey C, Whale A, van Dyk N. Neck Strength Assessment Offers No Clinical Value in Predicting Concussion in Male Professional Rugby Players: A Prospective Cohort Study. J Orthop Sports Phys Ther 2023; 53:317–323. [PMID: 37017931 DOI: 10.2519/jospt.2023.11723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVE: To determine if neck muscle strength and endurance are associated with concussion injuries in professional, male rugby players. Playing position, history of previous concussion, and age were also considered. DESIGN: Prospective cohort study METHODS: One hundred thirty-six male, professional rugby players completed neck strength testing that comprised a peak isometric test, an endurance test, and a concussion screening questionnaire. Electronic medical records were analyzed for head injury data. RESULTS: Out of 136 players (mean age, 25.3 ± 3.4 years; height, 186 ± 7 cm; weight, 103 ± 13.2 kg), 40 players suffered from 51 concussions in the 2017/18 playing season. A history of concussion was reported by 65% of the cohort. Multiple logistic regression analysis found that peak isometric flexion strength was not associated with concussion risk. Increased peak isometric extension strength was associated with significantly greater odds of sustaining a concussion (odds ratio [OR] = 1.01; 95% CI: 1.00, 1.01, does not include 1; P = .04) that is likely too small to be clinically relevant. Players with a self-reported history of concussion had over 2 times greater odds of sustaining a concussion (OR = 2.25; 95% CI: 0.73, 6.22). More than 2 concussions in the past 12 months was associated with almost tenfold greater odds of concussion (OR = 9.51; 95% CI: 1.66, 54.55). Age, playing position, and neck muscle endurance were not associated with concussion. CONCLUSION: The strongest predictor of concussion injury was previous concussion. Players who sustained concussions in season had similar neck muscle strength to players who had not sustained a concussion. J Orthop Sports Phys Ther 2023;53(5):1-7. Epub: 5 April 2023. doi:10.2519/jospt.2023.11723.
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Affiliation(s)
- Mairead Liston
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Chris Leckey
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Andrew Whale
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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11
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Injury Occurrence in Amateur Rugby: Prospective Analysis of Specific Predictors over One Half-Season. Medicina (B Aires) 2023; 59:medicina59030579. [PMID: 36984581 PMCID: PMC10055806 DOI: 10.3390/medicina59030579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Background and objectives: The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically analyse sports and injury factors as potential predictors of musculoskeletal injuries in senior-level amateur rugby players. Methods: The participants in this study were 101 senior-level rugby players from Croatia (average of 24.64 years old). At baseline, all participants were tested on sociodemographic and anthropometric parameters (age, body height and mass), consumption of dietary supplements, preseason injury status and training volume, and sport factors (position in game). Data on injury occurrence (dependent variable), prevalence of pain, training status, and characteristics of the played match were surveyed prospectively once a week during the three-month period (one half-season). Results: The logistic regression revealed a higher injury occurrence in forward players of the 1st row, 2nd row (OR = 5.07; 95% CI: 1.64–15.69), and center (OR = 4.72; 95% CI: 1.28–14.31), with reference to outside back players. When observed univariately, higher body mass, higher level of competition, more weekly training sessions, self-perceived pain, and playing with pain were significant injury risk factors. The multivariate logistic regression identified pre-season injury (OR = 1.30, 95% CI: 1.09–1.52), higher level of the game/match (OR = 1.44, 95% CI: 1.13–1.76), higher body mass (OR = 1.03, 95% CI: 1.01–1.05), and pain prevalence (OR = 5.71, 95% CI: 3.22-7.70) as multivariate predictors of injury occurrence over the season. Conclusion: The results of this study showed that among sport factors, the playing position, level of competition, and training exposure represent major injury risk factors. Therefore, in order to reduce the number of injuries, special emphasis should be placed on the specific tackling technique of forward players, which could both increase their situational efficiency and protect them from injuries. Additionally, perceived pain, injury history, and playing with injury were noted among injury factors as the ones that can be predictors of future injuries. In that manner, it is important that coaching and medical staff monitor players with previous injuries and with pain symptoms in order to act preventively against injury occurrence.
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12
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Chavarro-Nieto C, Beaven M, Gill N, Hébert-Losier K. Hamstrings injury incidence, risk factors, and prevention in Rugby Union players: a systematic review. PHYSICIAN SPORTSMED 2023; 51:1-19. [PMID: 34637371 DOI: 10.1080/00913847.2021.1992601] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Hamstring strain injuries are one of the most common injuries in Rugby Union, representing up to 15% of all injuries sustained. We aimed to systematically review and summarize the scientific literature that addressed hamstring strain injury incidence, risk factors, injury prevention or strengthening strategies, and strength or asymmetry measures in Rugby Union. METHODS We conducted a systematic search to locate published peer-reviewed articles from PubMed, SPORTDiscusTM, Web of Science®, and Scopus® e-databases. Studies included were original research conducted in Rugby Union that evaluated hamstring strength, hamstring strengthening interventions, and/or hamstring injury outcomes. Included studies were quality assessed using the Newcastle-Ottawa Scale. RESULTS Twenty-four studies met inclusion and altogether involved 2866 participants. Isokinetic testing was the most common method used to quantify hamstring strength and imbalances in Rugby Union; with data indicating that professionals are stronger than amateurs, and forwards are stronger than backs. Regarding risk factors, we identified playing position, fatigue, previous injuries, between leg strength imbalances, lack of readiness to return to play post injury, and game actions (i.e. running). There is evidence to support the use of Nordic eccentric strength measures to inform practice, with strength and imbalances useful in predicting injuries. Strengthening programs with Nordic exercises significantly increased hamstring strength, increased muscle thickness, and decreased imbalance ratios in female and male players. A significant reduction in injury incidence and severity in professional players has been observed in players performing routines incorporating progressive Nordic exercises. CONCLUSION The etiology of hamstring strain injuries is multifactorial, with playing position, fatigue, previous injuries, leg imbalances, lack of readiness to return to play, and running actions identified as contributing factors across levels. Combining strategies to prevent hamstring injuries and recurrences, and to inform return to play, is likely worthwhile and should include Nordic strength assessment and Nordic exercises.
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Affiliation(s)
- Christian Chavarro-Nieto
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga, New Zealand
| | - Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga, New Zealand
| | - Nicholas Gill
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga, New Zealand.,New Zealand Rugby, Wellington, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga, New Zealand
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13
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Cronin K, Foley S, Cournane S, De Vito G, Kerin F, Farrell G, Delahunt E. The architectural characteristics of the hamstring muscles do not differ between male and female elite-level rugby union players. Front Physiol 2023; 14:1129061. [PMID: 36776970 PMCID: PMC9911870 DOI: 10.3389/fphys.2023.1129061] [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: 12/21/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Purpose: To determine whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Methods: Forty elite-level rugby union players (male n = 20, female n = 20) participated in this cross-sectional study. A sonographer acquired static ultrasound images using a 92 mm linear transducer to quantify (via a semi-automated tracing software tool) the architectural characteristics (muscle length, fascicle length, pennation angle, and muscle thickness) of the biceps femoris long head and semimembranosus muscles of participants' left limb. Muscle length and muscle thickness of the biceps femoris short head and semitendinosus muscles of participants' left limb were also quantified. Bonferroni adjusted independent samples t-tests were performed to evaluate whether differences exist in the architectural characteristics of the hamstring muscles of elite-level male and female rugby union players. Results: There were no significant differences in fascicle length or pennation angle of the hamstring muscles of elite-level male and female rugby union players. Some significant differences in muscle thickness (biceps femoris short head, and semimembranosus) and muscle length (biceps femoris short head, biceps femoris long head, semitendinosus, and semimembranosus) were observed; in all cases the male players had thicker and longer muscles. Conclusion: At a group level, hamstring muscle fascicle length and pennation angle are unlikely to be a sex-specific intrinsic risk factor for Hamstring strain injuries.
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Affiliation(s)
- Kevin Cronin
- School of Medicine, University College Dublin, Dublin, Ireland,*Correspondence: Kevin Cronin,
| | - Shane Foley
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Seán Cournane
- School of Physics, University College Dublin, Dublin, Ireland
| | - Giuseppe De Vito
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Fearghal Kerin
- Leinster Rugby, Dublin, Ireland,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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14
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Cruz-Ferreira AM, Montocchio A, Usova-Akula E, Tuccelli P, Marty F. 2021/22 Rugby Europe Injury Surveillance Report: SuperCup, Under-20, and Under-18 Championship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1800. [PMID: 36767165 PMCID: PMC9914350 DOI: 10.3390/ijerph20031800] [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: 11/30/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
We conducted a prospective cohort study to determine the incidence rate and characterization of the injuries sustained by players during the 2021/22 season of the Rugby Europe SuperCup, Under-20, and Under-18 championships. Team medics reported the injuries, using an online platform. Ethical approval and informed consent were obtained. The overall incidence of injuries ranged from 33.33 (95% CI: 18.97-54.60) in the under-18s to 83.33 (95% CI: 60.34-112.40) in the under-20s, while in the SuperCup it was 41.35 (95% CI: 30.30-55.18) injuries per 1000 player-match-hours. Injury severity (mean days) was higher in the SuperCup (38.33) and lower in the Under-18 tournament (28.50). Lower limb and soft tissue were the most common type of injuries. Tackles caused almost two-thirds of all injuries. Concussion accounted for 10.0% to 25.6% of all injuries. Our data are consistent with previous reports for similar levels of competition and age grades. The injury incidence was higher in the senior competitions (Under-20s and SuperCup). However, for the under-20s, injury rates were higher than in the SuperCup. This might be related to the competition format; however, more studies need to be conducted in the future. Concussion is a common injury and the protocols used at this level seems to be effective to identify it.
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Affiliation(s)
- António Miguel Cruz-Ferreira
- Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal
- CEISUC–Center for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal
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15
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Chavarro-Nieto C, Beaven M, Gill N, Hébert-Losier K. Reliability of Repeated Nordic Hamstring Strength in Rugby Players Using a Load Cell Device. SENSORS (BASEL, SWITZERLAND) 2022; 22:9756. [PMID: 36560125 PMCID: PMC9785535 DOI: 10.3390/s22249756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
Hamstring strain injuries are one of the most common injuries in Rugby Union players, representing up to 15% of all sustained injuries. The Nordic eccentric hamstring test assesses the maximal hamstring eccentric strength and imbalances between limbs. Asymmetries and deficits in hamstring strength between legs are commonly assessed and used as screening methods to prevent injuries which can only be proven effective if hamstring strength measures are reliable over time. We conducted a repeated-measures reliability study with 25 male Rugby Union players. Nordic eccentric strength and bilateral strength balance was assessed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors (TE), coefficient of variations (CV), and intraclass correlation coefficients (ICC). Our results showed good intrasession reliability (ICC = 0.79-0.90, TE = 26.8 N to 28.9 N, CV = 5.5% to 6.7%), whilst intersession reliability was fair for mean and the max (ICC = 0.52-0.64, TE = 44.1 N to 55.9 N, CV from 7.4% to 12.5%). Regarding the bilateral strength balance ratios, our results showed good intrasession reliability (ICC = 0.62-0.89, TE = 0.5, CV = 4.4% to 7.2%), whilst the intersession reliability for mean and max values was fair (ICC = 0.52-0.54) with a good absolute intersession reliability CV ranging from 8.2% to 9.6%. Assessing the Nordic eccentric hamstring strength and the bilateral strength balance in Rugby players using a load cell device is a feasible method to test, and demonstrated good intrasession and fair intersession reliability. Nordic eccentric strength assessment is a more practical and functional test than isokinetic; we provide data from Rugby Union players to inform clinicians, and to establish normative values in this cohort.
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Affiliation(s)
- Christian Chavarro-Nieto
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga 3116, New Zealand
| | - Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga 3116, New Zealand
| | - Nicholas Gill
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga 3116, New Zealand
- New Zealand Rugby, Wellington 6011, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Adams Centre for High Performance, Tauranga 3116, New Zealand
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16
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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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17
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Tondelli E, Boerio C, Andreu M, Antinori S. Impact, incidence and prevalence of musculoskeletal injuries in senior amateur male rugby: epidemiological study. PHYSICIAN SPORTSMED 2022; 50:269-275. [PMID: 33906560 DOI: 10.1080/00913847.2021.1924045] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Exposure to different types of injuries in rugby union is common. It is important to know about the injury epidemiology for medical teams care in order to optimize players´ performance and the treatment of common injuries, but there is limited specific information related to amateur rugby union. The purpose of this study is to determine the incidence, prevalence, injury burden, severity, nature of injuries sustained by senior amateur male rugby players from three clubs in Argentina during a given season. METHODS An observational, analytical, prospective, multicenter study was developed. Data collection was conducted from 15 March 2019 to 2 November 2019, during a complete season under the applicable standards of the Rugby Injury Consensus Group according to the Orchard Sports Injury and Illness Classification System.Incidence (injuries/1000 player-match-hours), prevalence (%), severity (time loss), injury burden (days lost/1000 player-match-hours), injured location and type of injury (%) were estimated. RESULTS 250 players and 180 injuries were assessed. Injury prevalence was 52.4%. Incidence rate per match and training was 30.9/1000 player-match-hours, and 0.77/1000 player-training-hours, respectively.The median injury severity score was 23 (IQR 12.7-52) days lost accounting for an injury burden of 97.3/1000 player-hours. Of the total, 113 (62.8%) injuries were contact injuries. The lower limbs were the most commonly affected (58.9%). Hamstring strain injury had the highest incidence and anterior cruciate ligament tear was the most severe injury. CONCLUSION The prevalence, incidence, and injury burden reported in this study are unprecedented and would add knowledge for the amateur rugby union community. Trainers, physicians, and physical therapists, should consider it to improve their clinical practice.
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Affiliation(s)
- Eduardo Tondelli
- Department of Physical Therapy and Sport Medicine, Rugby Club Los Matreros, Castelar, Buenos Aires, Argentina
| | - Carlos Boerio
- Department of Physical Therapy and Sport Medicine, Old Resian Club, Rosario, Argentina
| | - Mauro Andreu
- Biostatistician, Universidad Nacional De La Matanza (Unlam), San Justo, Argentina
| | - Santiago Antinori
- Department of Physical Therapy and Sport Medicine, Club Universitario De Córdoba, Córdoba, Argentina
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18
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Chia L, De Oliveira Silva D, Whalan M, McKay MJ, Sullivan J, Fuller CW, Pappas E. Non-contact Anterior Cruciate Ligament Injury Epidemiology in Team-Ball Sports: A Systematic Review with Meta-analysis by Sex, Age, Sport, Participation Level, and Exposure Type. Sports Med 2022; 52:2447-2467. [PMID: 35622227 PMCID: PMC9136558 DOI: 10.1007/s40279-022-01697-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2022] [Indexed: 01/18/2023]
Abstract
Background Not all anterior cruciate ligament (ACL) injuries are preventable. While some ACL injuries are unavoidable such as those resulting from a tackle, others that occur in non-contact situations like twisting and turning in the absence of external contact might be more preventable. Because ACL injuries commonly occur in team ball-sports that involve jumping, landing and cutting manoeuvres, accurate information about the epidemiology of non-contact ACL injuries in these sports is needed to quantify their extent and burden to guide resource allocation for risk-reduction efforts. Objective To synthesize the evidence on the incidence and proportion of non-contact to total ACL injuries by sex, age, sport, participation level and exposure type in team ball-sports. Methods Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, Scopus and SPORTDiscus) were searched from inception to July 2021. Cohort studies of team ball-sports reporting number of knee injuries as a function of exposure and injury mechanism were included. Results Forty-five studies covering 13 team ball-sports were included. The overall proportion of non-contact to total ACL injuries was 55% (95% CI 48–62, I2 = 82%; females: 63%, 95% CI 53–71, I2 = 84%; males: 50%, 95% CI 42–58, I2 = 86%). The overall incidence of non-contact ACL injuries was 0.07 per 1000 player-hours (95% CI 0.05–0.10, I2 = 77%), and 0.05 per 1000 player-exposures (95% CI 0.03–0.07, I2 = 97%). Injury incidence was higher in female athletes (0.14 per 1000 player-hours, 95% CI 0.10–0.19, I2 = 40%) than male athletes (0.05 per 1000 player-hours, 95% CI 0.03–0.07, I2 = 48%), and this difference was significant. Injury incidence during competition was higher (0.48 per 1000 player-hours, 95% CI 0.32–0.72, I2 = 77%; 0.32 per 1000 player-exposures, 95% CI 0.15–0.70, I2 = 96%) than during training (0.04 per 1000 player-hours, 95% CI 0.02–0.07, I2 = 63%; 0.02 per 1000 player-exposures, 95% CI 0.01–0.05, I2 = 86%) and these differences were significant. Heterogeneity across studies was generally high. Conclusion This study quantifies several key epidemiological findings for ACL injuries in team ball-sports. Non-contact ACL injuries represented over half of all ACL injuries sustained. The proportion of non-contact to total ACL injuries and injury incidence were higher in female than in male athletes. Injuries mostly occurred in competition settings. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-022-01697-w.
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Affiliation(s)
- Lionel Chia
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Physiotherapy, The University of Sydney, Sydney, NSW, Australia. .,Cleveland Guardians Baseball Company, Cleveland, OH, USA.
| | - Danilo De Oliveira Silva
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, VIC, Australia
| | - Matthew Whalan
- Research and Development Department, Football Australia, Sydney, NSW, Australia.,Centre of Medical and Exercise Physiology, School of Medical, Indigenous & Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Marnee J McKay
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Physiotherapy, The University of Sydney, Sydney, NSW, Australia
| | - Justin Sullivan
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Physiotherapy, The University of Sydney, Sydney, NSW, Australia
| | | | - Evangelos Pappas
- Faculty of Medicine and Health, Sydney School of Health Sciences, Discipline of Physiotherapy, The University of Sydney, Sydney, NSW, Australia.,School of Medicine and Illawarra Health and Medical Research Institute, The University of Wollongong, Wollongong, NSW, Australia
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19
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Purcell C, Duignan C, Fullen B, Caulfield B. Assessment and classification of peripheral pain in athletes: a scoping review protocol. BMJ Open Sport Exerc Med 2021; 7:e001215. [PMID: 35028159 PMCID: PMC8719172 DOI: 10.1136/bmjsem-2021-001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/04/2022] Open
Abstract
Pain is often presumed to be part of the sport injury experience. The time-loss definition of injury leads to under-reported athletic pain impacting performance and quality of life. Whilst research regarding the assessment and classification of back pain in athletes is emerging, little has been reported regarding how peripheral pain is assessed and classified in research and practice. Six databases will be searched for relevant articles. Title and abstract screening followed by full-text screening will be completed by two independent reviewers. Data charting will be carried out using a modified standardised form. Descriptive results and frequencies will be reported. Pain measures identified in the studies will be mapped against the IOC Athlete Pain Framework alongside a narrative summary. Published peer-reviewed primary research studies alongside systematic reviews and clinical practice guidelines reporting the assessment or classification of pain in athletes of any age with chronic or acute peripheral pain across all study contexts in the English language on human participants from inception of the databases will be included. The results of this study are part of a body of research which will be used to inform the development of a pain assessment framework. The scoping review will be submitted for peer-reviewed journal publication and presented at sports medicine conferences. This review will inform researchers and clinicians working with athletes in pain how pain assessment and classification is currently conducted and positioned against the IOC Athlete Pain Framework.
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Affiliation(s)
- Ciarán Purcell
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Ciara Duignan
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Brona Fullen
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Brian Caulfield
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, University College Dublin, Dublin, Ireland
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20
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Williams S, Robertson C, Starling L, McKay C, West S, Brown J, Stokes K. Injuries in Elite Men's Rugby Union: An Updated (2012-2020) Meta-Analysis of 11,620 Match and Training Injuries. Sports Med 2021; 52:1127-1140. [PMID: 34854059 PMCID: PMC9023408 DOI: 10.1007/s40279-021-01603-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/04/2022]
Abstract
Background The most recent meta-analytic review of injuries in elite senior men’s Rugby Union was published in 2013. The demands of the game at the elite level are continually changing alongside law amendments and developments in player preparation. As such, an updated meta-analysis of injury data in this setting is necessary. Objective To meta-analyse time-loss injury data in elite senior men’s Rugby Union between 2012 and 2020. Methods Electronic databases were searched using the keywords ‘rugby’ and ‘inj*’. Nineteen studies met the inclusion criteria. Injury incidence rate data were modelled using a mixed-effects Poisson regression model. Days missed data were modelled using a general linear mixed model. Results The included data encompassed a total of 8819 match injuries and 2801 training injuries. The overall incidence rate of injuries in matches was 91 per 1000 h (95% confidence interval (CI) 77–106). The estimated mean days missed per match injury was 27 days (95% CI 23–32). The overall incidence rate of match concussions was 12 per 1000 h (95% CI 9–15). The overall incidence rate of training injuries was 2.8 per 1000 h (95% CI 1.9–4.0). Playing level was not a significant effect modifier for any outcome. Conclusions The injury incidence rate and mean days missed per injury in the present meta-analysis were higher, but statistically equivalent to, the 2013 meta-analysis (81 per 1000 h and 20 days, respectively). The injury incidence rate for match injuries in elite senior men’s Rugby Union is high in comparison to most team sports, though the training injury incidence rate compares favourably. The tackle event and concussion injuries should continue to be the focus of future preventative efforts. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01603-w.
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Affiliation(s)
- Sean Williams
- Centre for Health and Injury and Illness Prevention in Sport, Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - Charli Robertson
- Centre for Health and Injury and Illness Prevention in Sport, Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Lindsay Starling
- Centre for Health and Injury and Illness Prevention in Sport, Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Carly McKay
- Centre for Health and Injury and Illness Prevention in Sport, Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Stephen West
- Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - James Brown
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Institute of Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa.,IOC Research Centre, Pretoria, South Africa
| | - Keith Stokes
- Centre for Health and Injury and Illness Prevention in Sport, Department for Health, University of Bath, Bath, BA2 7AY, UK.,Rugby Football Union, Twickenham, UK
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21
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Tierney GJ, Tucker R. The role of player mass and contact speed on head kinematics and neck dynamics in rugby union tackling. Scand J Med Sci Sports 2021; 32:298-312. [PMID: 34741337 DOI: 10.1111/sms.14090] [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: 06/17/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Abstract
Tackling is the most common cause of general injuries in rugby union, with player speed and mass identified as risk factors. This study aimed to use multibody modeling simulations to examine how tackler and ball carrier mass and contact speed affect inertial head kinematics and neck dynamics. Simulations were run by independently varying the ball carrier and tackler mass (from 60 to 110kg) and speed (from 0 to 10 m/s). Peak resultant inertial neck dynamics (force and moment) and head kinematics (linear acceleration, angular acceleration, and angular velocity) were extracted from each simulation. The greatest inertial head kinematics and neck dynamics sustained by a player was when there was the greatest mass disparity in the tackle, with the lighter player experiencing greatest inertial neck dynamics and head kinematics by up to 24% in comparison with the scenario when both players were the lightest mass (60 kg). As a player's mass increased, the magnitude of their head kinematics and neck dynamics diminished, but increased for their direct opponent, irrespective of whether they were the tackler or ball carrier. For speed, the greatest inertial head kinematics and neck dynamics sustained by the ball carrier and tackler were when they were both traveling at the highest speed. In theory, large discrepancies in mass of players, and high speeds into a tackle should be avoided.
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Affiliation(s)
- Gregory J Tierney
- School of Sport, Ulster University, Belfast, UK.,School of Biomedical Sciences, University of Leeds, Leads, UK.,Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
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22
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Chavarro-Nieto C, Beaven M, Gill N, Hébert-Losier K. Neck strength in Rugby Union players: a systematic review of the literature. PHYSICIAN SPORTSMED 2021; 49:392-409. [PMID: 33554689 DOI: 10.1080/00913847.2021.1886574] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The incidence and severity of concussion injuries are increasing every year. Scientific evidence indicates that neck strength and girth could play a role in preventing head and neck injuries, or at least mitigating their severity. We aimed to examine the scientific literature addressing neck strength in Rugby Union with a focus on the potential role of neck strength on injury incidence, neck assessment protocols, neck strength measures, and neck strengthening exercises.We conducted a systematic search of the literature in January 2021 to locate published peer-reviewed articles from PubMed, SPORTDiscusTM, Web of Science®, and Scopus® e-databases. Overall, senior elite male players were stronger than younger-aged players. Forwards were stronger in extension than any other directions assessed, and were generally stronger and possessed larger necks and greater cross-sectional areas when compared to backs. Implementation of isometric exercise routines in professional players was reported to improve neck strength in all directions. There were no studies evaluating the incidence of concussion and neck strength or neck strengthening strategies in Rugby Union. Strengthening the neck continues to be one of the targeted modifiable risk factors with respect to limiting the severity and temporal effects of head injuries in Rugby Union, despite limited evidence regarding direct associations between neck strength and concussion.
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Affiliation(s)
- Christian Chavarro-Nieto
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Nicholas Gill
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand.,New Zealand Rugby, Thorndon, Wellington, New Zealand
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
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23
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Chéradame J, Piscione J, Carling C, Guinoiseau JP, Dufour B, Jacqmin-Gadda H, Decq P. Incidence and Risk Factors in Concussion Events: A 5-Season Study in the French Top 14 Rugby Union Championship. Am J Sports Med 2021; 49:1921-1928. [PMID: 33861663 DOI: 10.1177/03635465211006480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Concussions are a source of major concern in rugby, and a limited number of studies have attempted to identify risk factors for these injuries. PURPOSE To investigate the incidence of match concussion and associated risk factors, including individual workload, anthropometric variables, playing position, and season phase, in elite rugby union players. STUDY DESIGN Case-control study; Level of evidence 3. METHODS All concussions and explanatory variables were collected for every match over 5 consecutive seasons (2014-2018) in 1334 professional players participating in the French Top 14 championship. Concussion risk was estimated using mixed effects Poisson regression. RESULTS Mean match concussion incidence equated to 10.4 (95% CI, 9.3-11.5) concussions for 1000 hours of game exposure. A peak was reached in the 2016-2017 season (13.7; 95% CI, 11.0-16.5). A greater risk was observed in the playoffs as compared with the first phase of the season (incidence rate ratio, 3.96; 95% CI, 2.10-7.35). In comparison with other positions, half-backs incurred the highest rate of concussion events (incidence, 16.1; 95% CI, 11.8-20.3). Irrespective of playing position, those with greater height and lower body mass reported a higher risk of concussions (P = .02), especially during tackling actions for lighter players (P = .01) and during other match events for taller players (P = .03). When adjusted for season phase, players who had accumulated a higher amount of playing time since the beginning of the season demonstrated a lower risk of concussion (P = .005). CONCLUSION Inter- and intraseasonal variations in concussion rates were observed. Within positional groups, lighter and taller players were more at risk, with the highest incidence generally observed in half-backs. Workload was measured by the number of matches played before a concussion event, and it appeared to have a protective rather than deleterious effect on concussion risk.
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Affiliation(s)
- Jérémy Chéradame
- Research Department, French Rugby Union Federation, Marcoussis, France
| | - Julien Piscione
- Research Department, French Rugby Union Federation, Marcoussis, France
| | | | | | - Bernard Dufour
- Medical Department, French National Rugby League, Paris, France
| | - Hélène Jacqmin-Gadda
- Université de Bordeaux, Inserm, Bordeaux Population Health U1219, ISPED, Bordeaux, France
| | - Philippe Decq
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech et Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Neurochirurgie, Clichy, France
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24
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Antrobus MR, Brazier J, Stebbings GK, Day SH, Heffernan SM, Kilduff LP, Erskine RM, Williams AG. Genetic Factors That Could Affect Concussion Risk in Elite Rugby. Sports (Basel) 2021; 9:19. [PMID: 33499151 PMCID: PMC7910946 DOI: 10.3390/sports9020019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 11/16/2022] Open
Abstract
Elite rugby league and union have some of the highest reported rates of concussion (mild traumatic brain injury) in professional sport due in part to their full-contact high-velocity collision-based nature. Currently, concussions are the most commonly reported match injury during the tackle for both the ball carrier and the tackler (8-28 concussions per 1000 player match hours) and reports exist of reduced cognitive function and long-term health consequences that can end a playing career and produce continued ill health. Concussion is a complex phenotype, influenced by environmental factors and an individual's genetic predisposition. This article reviews concussion incidence within elite rugby and addresses the biomechanics and pathophysiology of concussion and how genetic predisposition may influence incidence, severity and outcome. Associations have been reported between a variety of genetic variants and traumatic brain injury. However, little effort has been devoted to the study of genetic associations with concussion within elite rugby players. Due to a growing understanding of the molecular characteristics underpinning the pathophysiology of concussion, investigating genetic variation within elite rugby is a viable and worthy proposition. Therefore, we propose from this review that several genetic variants within or near candidate genes of interest, namely APOE, MAPT, IL6R, COMT, SLC6A4, 5-HTTLPR, DRD2, DRD4, ANKK1, BDNF and GRIN2A, warrant further study within elite rugby and other sports involving high-velocity collisions.
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Affiliation(s)
- Mark R. Antrobus
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Sport and Exercise Science, University of Northampton, Northampton NN1 5PH, UK
| | - Jon Brazier
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Department of Psychology and Sports Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Georgina K. Stebbings
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
| | - Stephen H. Day
- Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK;
| | - Shane M. Heffernan
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea SA1 8EN, UK; (S.M.H.); (L.P.K.)
| | - Liam P. Kilduff
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea SA1 8EN, UK; (S.M.H.); (L.P.K.)
| | - Robert M. Erskine
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK;
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
| | - Alun G. Williams
- Sports Genomics Laboratory, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester M1 5GD, UK; (J.B.); (G.K.S.); (A.G.W.)
- Institute of Sport, Exercise and Health, University College London, London WC1E 6BT, UK
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25
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Fuller CW, Taylor A. Eight-season epidemiological study of match injuries in women's international rugby sevens. J Sports Sci 2020; 39:865-874. [PMID: 33225825 DOI: 10.1080/02640414.2020.1850616] [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] [Indexed: 10/22/2022]
Abstract
This study aimed to describe anthropometry and incidence, nature and causes of match injuries in women's international rugby sevens and to compare these with results reported previously for men's international rugby sevens. The study comprised an 8-season, prospective study of World Rugby's women's Sevens World Series. Over the eight seasons, the overall incidence of injury was 105.6 (95% CI: 96.0 to 116.3) injuries/1000 player-match-hours with a mean injury severity of 53.4 (95% CI: 46.9 to 59.9) days-absence. There were no statistically significant trends for backs or forwards in the incidence (backs: p = 0.470; forwards: p = 0.242) or mean severity (backs: p = 0.098; forwards: p = 0.544) of injuries sustained over the 8-season period. Head/face (20.8%), knee (19.7%), ankle (11.3%) and shoulder/clavicle (8.4%) were the most common injury locations while ligament sprain (31.7%), concussion (15.6%), haematoma/bruise (11.5%) and fracture (11.5%) were the most common types of injury sustained. Being-tackled (35.4%), tackling (26.3%), collisions (13.8%) and rucks (8.8%) were the match events responsible for most injuries. The study indicates that injury burden in women's international rugby sevens (5,640 days-absence/1000 player-match-hours; 95% CI: 5,123 to 6,209) is similar to that reported previously for men's international rugby sevens (5,263 days-absence/1000 player-match-hours; 95% CI: 5,000 to 5,540).
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Affiliation(s)
- Colin W Fuller
- Colin Fuller Consultancy Ltd, Sutton Bonington, UK.,World Rugby, Dublin, Ireland
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