Category: Concussion
Rugby Science Update 3
A game for all shapes and sizes? Changes in anthropometric and performance measures of elite professional rugby union players 1999–2018
This study aimed to assess the longitudinal changes in mass, velocity, momentum and peak kinetic energy using two decades of standardised elite and international rugby player data. The study showed that professional players are now leaner, heavier, faster and cover more distance than ever before. When professional rugby players collide, the forces involved have also risen. The implications of these findings however are yet to be fully understood.
This article is open access and free to download on the journal’s website.
Poor isometric neck extension strength as a risk factor for concussion in male professional Rugby Union players
This study aimed to establish if reduced neck strength was a risk factor for concussion in professional male rugby players. The study identified a specific neck strength range associated with increased concussion rates and found that reduced neck extension strength is a risk factor for concussion in male professional rugby players.
Effectiveness of the Activate injury prevention exercise programme to prevent injury in schoolboy rugby union
The main aim of this study was to assess the effectiveness of Activate (a 15–20 min warm-up programme) to lower match and training injury rates (incidence and burden) in schoolboy rugby union (under-12 to under-19). A secondary aim was to examine the dose–response relationship between weekly Activate adherence and injury incidence. The study found individuals playing for teams adopting Activate had a lower match and training injury incidence when compared with those not using Activate. Individuals with high weekly Activate adherence (≥3 Activate sessions per week) had a lower match and training injury incidence than those with low adherence (<1 Activate session per week). Therefore, Activate appears effective at lowering injury risk in schoolboy rugby union, with maximum benefit when completing the programme three times per week.
Rugby Science Update 2
Comparison of Weightlifting, Traditional Resistance Training and Plyometrics on Strength, Power and Speed: A Systematic Review with Meta-Analysis
This review aimed to explore whether weightlifting resulted in greater improvements in measures of strength, power, speed and change of direction speed compared with traditional resistance training, plyometric training or controls. Findings from 16 studies suggested there are moderate to large benefits of weightlifting for improvements in strength, counter movement jump, squat jump and speed performance when compared with no additional training beyond sports practice or typical physical activities. Whilst improvements in strength were found to be similar following both weightlifting and traditional resistance training, weightlifting may be superior for improvements in weightlifting performance (i.e. load lifted) and counter movement jump height. Factors such as population characteristics or programme design may also influence these outcomes.
This article is open access and the full article is free to download.
What Learning Environments Help Improve Decision-Making?
This study attempted to provide a greater understanding of coaches’ perceptions and strategies for specifically developing on-ball decision-making abilities in players. In the paper, the authors were interested in what strategies coaches believe would improve player decision-making, how they would create a learning environment to specifically train decision-making, and how this may influence the on-ball decision-making opportunities for the players.
The study found coaches are aware of the strategies which may promote decision-making opportunities for players such as the use of questioning, constraints-led pedagogy and using Playing Form rather than Training Form activities. While the data may suggest coaches are aware of potential strategies to promote player decision-making and are attempting to move away from traditional coaching approaches, the findings provide evidence to suggest that coaches still over-coach, with high amounts of instruction and a very stop-start nature to the activity. This coaching practice potentially limits the problem-solving and decision-making demands on players. The findings support researchers who indicate there is still a disconnect between intention and practice, with the application of more effective coaching methods proposed in the research still a challenge to implement for coaches.
Characteristics of Complex Systems in Sports Injury Rehabilitation: Examples and Implications for Practice
This review applies the complex systems approach to return to sport. The paper highlights the characteristics and terminologies of complex systems, using a case of anterior cruciate ligament injury rehabilitation. Alternative forms of scientific inquiry, such as the use of computational and simulation-based techniques, are also discussed—to move the complex systems approach from the theoretical to the practical level.
This article is open access and the full article is free to download.
Rugby and CTE
By Ken Quarrie
I have been seeing claims that some people are “sowing doubt” with respect to CTE (Chronic Traumatic Encephalopathy) and are thus acting like tobacco companies did with respect to heart diseases and lung cancer. I want to make a few comments about this. Before I get to the CTE issue, it is worthwhile that I put some background about me on the record, so that people are able to judge whether I am likely to have biases that might sway me to one position or another.
I was brought up in New Zealand, in a family where rugby was *very* important. Dad played rep rugby for Wanganui and Waikato, and was an All Blacks triallist. As a kid I was a fan and obsessively read books about rugby and the All Blacks. I played the sport from childhood until my late 20’s. I had some really enjoyable times along the way. I also sustained (at least) five concussions. I was immersed in the Otago Uni/Dunedin rugby heavy drinking culture.
I found that as I got older there were fewer aspects of the “rugby” culture with which I identified – @XTOTL captures some of that here: https://www.rnz.co.nz/news/the-wireless/374305/the-pencilsword-in-the-bin. I also had a good friend injured at the age of 15 in a scrum. He has been in a wheelchair since 1984.
As well as rugby, as a kid I loved science. I have managed to combine those two loves into a career. I wouldn’t call myself a rugby “fan” anymore. I am a rugby scientist, and it helps to have a little distance from your object of study. Nevertheless, I still work for NZ Rugby (conflict of interest klaxons!). Having worked on independent research studies examining risks for injury in the 1990’s, I took a role with NZ Rugby in 2000 as their first “Injury Prevention Manager”. I realised that, as a scientist, my employment represented a conflict of interest, but I believed I could have a greater impact on improving player safety and welfare from within rugby than from the outside.
I have been adamant with NZ Rugby and World Rugby that I must be allowed to conduct research without interference about what I can study, how I can analyse it, and what I can say about it. A look at my research outputs will reveal an eclectic mix of rugby studies. So when people “poison the well” by implying that any research funded by or conducted by sports organisations must necessarily be “suspect” I feel personally attacked. Doing good science is what I care about.
Doing good science is what I care about.
From a personal level, the welfare of players has, and does, take precedence for me over considerations of “tradition” or “maintaining the essence of the game”. But managing risks does not imply “eliminating all risks”. Reasonable people can look at an issue and disagree about it.
So – the “tobacco company line”. Tobacco companies systematically downplayed the risks of their products, and attempted to “sow doubt” in the public mind. How is the CTE/concussion debate different? A key difference is that, despite there having been strong claims made about what causes CTE, how it develops, and what clinical outcomes it leads to, the reality is that the science of CTE is very young. There really *is* a lot of doubt about a number of the issues!
The issues include whether CTE is, as has been claimed by some, a primary, progressive neurodegenerative disease. Questions remain about the cause(s) of the pathology. Questions remain about the “pathognomonic lesion” – i.e. what distinguishes CTE from other pathologies. Questions remain about the prevalence of the pathology. MAJOR questions remain about the relationship between having CTE pathology in the brain and any given clinical outcome. Do I think brain injuries are bad for health? Yes, undoubtably. I also think that the public perception of the strength of the evidence, and the prevalence of CTE as a public health issue doesn’t match the scientific understanding of it *at this point*.
So to accuse “rugby” as having acted like tobacco companies to sow doubt about CTE is simply a smear, and a lazy and demonstrably false one at that.
If former rugby players are struggling – for whatever reason – my heart is with them. I pledge to do my best to understand more about the long term health outcomes of playing rugby, so that people can better understand the risks and make informed choices about play. People involved in rugby, like Colin Fuller, @Sharief_H, @drkeithstokes, @drsimonkemp, @mattjcrossie, @Scienceofsport and yours truly and many others have identified and documented risks in rugby via research studies and injury surveillance. Many changes to rugby have been made as a result of that work. RugbySmart, BokSmart and other injury prevention programmes have been widely recognised within the sports science/sports medicine communities as having had positive effects on the risks of injuries. Likewise, the @NZRugbyFound has done great work on tertiary prevention. So to accuse “rugby” as having acted like tobacco companies to sow doubt about CTE is simply a smear, and a lazy and demonstrably false one at that.
Rugby Science 