Category: Concussion
Rugby Science Update 25
By Lara Paul
The aim of this study is to report the imaging findings of school-level players in low to middle income countries who presented to public or private radiology centre for imaging after sustaining traumatic rugby-related head injuries. The study further aims to examine: (1) the prevalence of concussion based on available clinical history; (2) the imaging correlation in players diagnosed with concussion and the diagnostic utility of CT in the context of concussion; and (3) differences in imaging findings between the public and private sectors. Data were collected from school-aged players (6-18 years) over a 10-year period, from 2014 to 2023, in the Western Cape region in South Africa. Imaging of rugby-related head injuries were obtained from Tygerberg Hospital, a public multi-centre facility, and from SCP Radiology, representing the private sector. Sports-related concussion (SRC) diagnoses were recorded only when signs or symptoms were included in the clinical history provided in the imaging request by the referring clinician and met the criteria based on the Sport Concussion Assessment Tool 6. A total of 369 school-level participants referred for imaging of rugby-related head injuries were included in this study. Participants in the public sector were over eight times more likely to have an SRC. This finding highlights disparities in healthcare access and injury reporting between the private and public sectors. Non-contrasted CT was the primary imaging modality used (94%). Eighty-six percent of scans showed no acute injury. Among abnormal studies, the most frequent findings were craniofacial fractures and brain injuries, including cerebral haemorrhage, contusions and oedema. SRC were prevalent in 78% of cases. Another noteworthy finding is that CT demonstrated low sensitivity for diagnosing concussion.
This study is published in Sports Medicine.
The purpose of this study was to compare three workload models and examine their relationships to match-specific and player specific characteristics in women’s rugby sevens. Twenty-two elite female rugby sevens players participated in the study. A total of 103 matches were analysed, incorporating GNSS-derived data, body mass measurements, self-reported RPE (rating of perceived exertion) and various match characteristics. The speed-deceleration-contact (SDC) model was used to generate predicted workload values, expressed in arbitrary units (AU). On average, players participated for 11.8 ± 4.53 minutes per match, experienced an RPE of 7 ± 1.9 AU, and had a calculated sRPE (session RPE) of 79.6 ± 45.59 AU, with 56.25 ± 21.40 kJ of mechanical work per match played. Player experience and match category significantly influenced all three workload measures (sRPE, mechanical work, and SDC model). Additionally, the opponent was significantly associated with both sRPE and the SDC model, while match outcome was associated with only sRPE. All three workload measures are valuable and are viable workload monitoring tools. However, they respond differently to contextual and experiential factors. Notably, sRPE and the SDC model appear more sensitive to key match characteristics compared to mechanical work.
This study is published in Applied Sciences.
Sleep architecture is altered with travel and matches in professional rugby union players
The purpose of this study was to compare the effects of home versus away match fixtures on sleep quantity, quality, and architecture in professional male rugby union players. Twenty (n = 20) professional male rugby union players participated during the first two rounds of the 2023 Super Rugby Pacific season, across two conditions: HOME and AWAY match fixtures. Sleep was assessed over three nights for each condition: the two nights preceding the match, the night of the match, and the second night following matchday. Two matches were separated by eight days, with the HOME fixture occurring first. Players wore a wireless home-based polysomnography PSG device on designated sleep assessment nights. Sleep was categorised into three groups: Sleep quantity, sleep quality and sleep architecture. Match day sleep duration was shorter than on the two preceding nights. Sleep efficiency was not affected by day or condition. Significant differences were observed in the proportion of time spent in light sleep (between conditions), deep sleep (across days), and REM sleep (by both day and condition). During AWAY fixtures, players experienced reduced light sleep and increased deep sleep, along with greater difficulty falling asleep. Regardless of match location, sleep duration was significantly reduced on the night of the match. Post-match sleep was characterized by reductions in light and REM sleep, and an increase in deep sleep. Overall, players exhibited lower proportions of REM sleep and higher proportions of deep sleep after matches compared to two nights preceding match day. These findings emphasise the importance of facilitating adequate sleep opportunities following travel and competition for professional rugby players.
This study is published in the Journal of Sport Science.
Rugby Science Update 23
By Lara Paul
The aim of this study was to examine the association between tackle characteristics and suspected concussion-related versus non-injurious tackle events in a Canadian female varsity rugby cohort using video analysis. Video footage from Canada West female varsity rugby union league, spanning 2017 to 2019, were analysed. A case-control study design was employed to evaluate the relationship between tackle characteristics and a suspected concussive tackle event. Tackle and head impact characteristics, such as contact direction, location, intensity, were coded. In total, 13 439 tackles were identified. Among 151 225 suspected injury events identified, 26% were classified as suspected concussions. Of these, 78% were attributed to tackle events, while the remaining concussions resulted from other match events, such as a scrums, mauls, or rucks. A high head impact intensity score was strongly associated with concussion for both ball carriers and tacklers. Tackler related suspected concussions were linked to tackle events involving three tacklers in a tackle event, a tap tackle and an away pre-contact head position. Ball carrier related suspected concussions were associated with a tap tackle, illegal tackle type and down pre-contact head position. Concussion prevention programmes and strategies should be prioritised in rugby. The findings of this study can guide the development of strategies and programmes focused on tackle types and head positioning for both tacklers and ball carriers.
This study is published in the International Journal of Performance Analysis in Sport.
The purpose of this study was to identify tackle characteristics associated with clinically diagnosed concussions in the men’s rugby league. Additionally, it aimed to determine the tackle characteristics that predict concussions in rugby league. Match concussions were reported throughout the 2018-2022 Super League seasons and were analysed using video analysis by the research team. In total, 7415 tackles that did not involve concussive events were coded, alongside the analysis of 196 concussions. Seventy percent (70%) occurred to the tackler, while thirty percent (30%) occurred to the ball carrier. Key tackle characteristics associated with concussions included the tackle impact location on the ball carrier’s body, the ball carrier leading arm, the number of defenders in the tackle, and the interaction of body positioning between the ball carrier and tackler. Specific characteristics for tacklers included tackler head placement, the ball carrier leading arm, number of players in the tackle, and tackle impact zone location on the ball carrier. For ball carrier concussions, tackle impact zone location on the ball carrier and the ball carrier and tackler body position. Tackle technique interventions should prioritise proper head placement to minimize direct impacts to the tackler’s head. Interestingly, this study found that the greatest odds of concussion occurred when both players were falling or diving rather than remaining upright. Tackles involving one ball carrier and three tacklers were the most frequent tackle type and had the lowest odds of causing concussion. Prioritising strategies focused on the tackler may significantly reduce overall concussions. Interventions should address initial impact with the ball carriers’ head or neck to decrease ball carrier concussions. Further research into optimal techniques for both ball carrier and tackers is needed. The findings of this study suggest that modifying and reinforcing tackle laws could help reduce the incidence of concussions in rugby league.
This study is published in Journal of Science and Medicine in Sport.
The aim of this study was to explore youth Rugby Union coaches’ preferences for education and support in implementing injury prevention programmes. Five focus group were conducted in 2023, involving twelve Rugby Union coaches from secondary school teams and youth clubs in Ireland. Data were collected until data saturation was reached, and a conventional content analysis approach was used to analyse the data and address the research question. Three main categories emerged from the analysis: 1) Formal/non-formal learning, 2) Informal learning, and 3) Intrapersonal considerations. Coaches expressed a preference for live, structured, and practical workshops during the pre-season period, which a strong focus on developing knowledge. The emphasized that injury prevention workshop should also be a stand-alone session to allow full attention to the topic. Coaches also requested active resources to aid in planning their programmes. These resources would enable coaches to develop implicit knowledge of injury prevention programmes through various means, including adapting, integrating, and engaging in Q&A sessions. Coaches also sought the flexibility to adjust programmes as needed. The study identified a mismatch between coaches’ preferences for injury prevention programme education and what is currently offered through National Governing Bodies coach education programmes. Further exploration of perspectives of National Governing Bodies is necessary to address this gap.
This study is published in Physical Therapy in Sport.
Rugby Science Update 20
By Lara Paul
The state of play for contact training and coaching in women’s rugby
The purpose of this study was to review the current literature on tackle training in contact rugby codes and highlight key messages for coaches and stakeholders as part of a transdisciplinary approach to improve science, safety and gender equity in women’s rugby. The review looked at female specific injury surveillance, prevention, coaches in women’s rugby and match demands. The current literature is sparse but acknowledges the gendered sociocultural and environmental conditions that have influenced women’s experiences of rugby contact and coaching. One cannot copy and paste what has been done from male literature and expect it to work for women’s rugby. Women’s rugby should be understood and coached in a context‐specific manner, considering the needs of the players, coaches and the training environment. Developing and encouraging coaches to execute safe and effective tackle technical actions has been highlighted a priority in women’s rugby. Researchers in all disciplines have been encouraged to work across all levels of women’s rugby, with coaches and athletes, to understand the whole system of women’s rugby. This allows for a holistic approach to developing women’s rugby further. This review also suggests that adapting and adopting progressive tackle skill training frameworks and gender‐responsive coaching practices can aid tackle skill learning.
This study is published in the European Journal of Sport Science – Open Access.
The aims of this study were two-fold: 1) to describe the Head Acceleration Events (HAEs) experienced by professional men’s rugby union players during contact events using statistical modelling techniques appropriate for instrumental mouthguard (iMG) data, and 2) to explore the differences between contact-event types and positional groups. This observational study was conducted during the 2023 Currie Cup and Super Rugby season. Custom Prevent Biometrics iMGs were provided to all players. Post-match data was downloaded from the iMGs to provide linear and angular kinematics. Video analysis data, provided by Opta, included ruck, ball carrier and tackle data. Accelerometer, gyroscope, and proximity sensor data were synchronized to video timestamps of contact events using Matlab. Each HAE was linked to a contact event if their timestamps occurred within 10 seconds of one another. The results from this study show that as the HAEmax magnitude increased, the probability of occurrence decreased. This results in a relatively small probability of higher HAEmax magnitudes in professional male rugby union players. Tackles and ball carries had a greater probability of HAEmax in higher magnitude ranges than rucks. However, the defensive ruck probability profile was closer to tackle and carry events than attacking rucks. The authors suggest that defensive rucks may warrant greater consideration within the injury prevention interventions. No clear differences were found between positions for any of the contact events. The occurrence of HAEmax was associated with roles players performed within contact events, not their actual playing position. These results of HAEmax occurrence can be used to guide and evaluate future HAE reduction strategies in professional rugby union players. Additionally, these results can guide practitioners in planning and player monitoring.
This study is published in Scandinavian Journal of Medicine & Science in Sports.
The purpose of this study to quantify changes in body composition, blood markers, energy requirements, strength, and aerobic capacity of women’s international rugby league players during the lead up to the 2022 Rugby League World Cup (RLWC). Twenty-four international women’s rugby league players participated in this study. Players were tested at three testing points: 1) December 2021, at the beginning of the 2022 Women’s Super League pre-season; 2) March 2022, at the end of the 2022 Women’s Super League pre-season; and 3) October 2022, following the completion of the 2022 Women’s Super League season and prior to the RLWC. Data collection included anthropometric measurements (height and body mass), body composition, resting metabolic rate (RMR), blood profiling, assessments of endurance capacity (VO2max) and isometric strength. This study observed increases in lean mass during the pre-season which aligned with the team’s training goals. Backs demonstrated improvements in VO2max across the three testing points. Interestingly, no significant changes were observed in fat mass, RMR, blood markers, or strength over time. Forwards has a greater body mass and body fat percentages compared to backs. The authors recommend the inclusion of iron profile monitoring in practical settings, especially during intensified training phases, as it can contribute to players’ overall health and performance. Although the iron profiles remained at similar levels across all testing points, it was below the recommended threshold.
This study is published in PLoS ONE.
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