Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

Matthew Attwood, Simon Roberts, Grant Trewartha, Mike England, Keith Stokes

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54 Citations (SciVal)


BACKGROUND: Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking.

OBJECTIVE: To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players.

METHODS: 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries.

RESULTS: Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).

CONCLUSIONS: The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.

Original languageEnglish
Article number290
Pages (from-to)368-374
Number of pages7
JournalBritish Journal of Sports Medicine
Issue number6
Early online date21 Oct 2017
Publication statusPublished - 1 Mar 2018

Bibliographical note

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


  • concussion
  • injury prevention
  • lower limb
  • neuromuscular
  • Single-Blind Method
  • Prospective Studies
  • Athletic Injuries/prevention & control
  • Humans
  • Male
  • Brain Concussion/prevention & control
  • Incidence
  • Young Adult
  • Football/injuries
  • Adult
  • Physical Conditioning, Human/methods

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine


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