Abstract
Objective: This systematic review (SR) and meta-analysis investigates rates and aetiology of injury and concussion, injury risk factors and evaluation of primary prevention strategies in youth rugby.
Data Sources: Nine databases were searched using 3 concepts: injury, youth, and rugby. The search was not limited by date and searches of reference lists of previous reviews was undertaken. Eligible studies were meta-analysed using a DerSimonian Laird random effect model for each age group and sex. Full search strategy and list of sources available on pre-registered Prospero (Ref: CRD42017065645).
Main Results: Sixty-four studies were included in this SR. The rates of match injury (using a 24-hour time loss definition) were 41.7/1000 match-hours (95% CIs: 13.6-69.9) in males and 53.0/1000 match-hours (95% CIs: 37.0-76.0) in females. Concussion rates were 6.2/1000 player-hours (95%CIs: 5.0-7.4) for males and 27/1000 player-hours (95% CIs: 13-41) for females. The most common injury site was the lower limb (males) and the head/neck (females). The most common injury type was ligament (males) and concussion (females). The mechanism of injury was a contact event for 84% of injuries, with the majority occurring in the tackle specifically (54% male, 62% females: in matches and training combined). Median injury severity was 21 days for males and 17 days for females. Twenty-one risk factors were reported in the literature, as well as 8 tackle-specific risk factors. The risk factors with the strongest evidence were higher level of play and increasing age. Primary injury prevention strategies were the focus of only 6 studies and included law changes (n = 2), equipment (n = 3) and training (n = 2) and targeted catastrophic injury (n = 3), all injury (n = 3) and traumatic brain injury/concussion (n = 4). The prevention strategies with the most promising evidence were mouthguard use and neuromuscular training.
Conclusions: There is a significant lack of empirical evidence in the female youth game, suggesting the need to prioritize female rugby players in future research. A focus on high-quality risk factors and primary prevention studies should be considered in examining risk factors for injury. Targeting primary prevention strategies and stakeholder education remain key strategies in the prevention, recognition, and management of injuries and concussions in youth rugby.
Data Sources: Nine databases were searched using 3 concepts: injury, youth, and rugby. The search was not limited by date and searches of reference lists of previous reviews was undertaken. Eligible studies were meta-analysed using a DerSimonian Laird random effect model for each age group and sex. Full search strategy and list of sources available on pre-registered Prospero (Ref: CRD42017065645).
Main Results: Sixty-four studies were included in this SR. The rates of match injury (using a 24-hour time loss definition) were 41.7/1000 match-hours (95% CIs: 13.6-69.9) in males and 53.0/1000 match-hours (95% CIs: 37.0-76.0) in females. Concussion rates were 6.2/1000 player-hours (95%CIs: 5.0-7.4) for males and 27/1000 player-hours (95% CIs: 13-41) for females. The most common injury site was the lower limb (males) and the head/neck (females). The most common injury type was ligament (males) and concussion (females). The mechanism of injury was a contact event for 84% of injuries, with the majority occurring in the tackle specifically (54% male, 62% females: in matches and training combined). Median injury severity was 21 days for males and 17 days for females. Twenty-one risk factors were reported in the literature, as well as 8 tackle-specific risk factors. The risk factors with the strongest evidence were higher level of play and increasing age. Primary injury prevention strategies were the focus of only 6 studies and included law changes (n = 2), equipment (n = 3) and training (n = 2) and targeted catastrophic injury (n = 3), all injury (n = 3) and traumatic brain injury/concussion (n = 4). The prevention strategies with the most promising evidence were mouthguard use and neuromuscular training.
Conclusions: There is a significant lack of empirical evidence in the female youth game, suggesting the need to prioritize female rugby players in future research. A focus on high-quality risk factors and primary prevention studies should be considered in examining risk factors for injury. Targeting primary prevention strategies and stakeholder education remain key strategies in the prevention, recognition, and management of injuries and concussions in youth rugby.
| Original language | English |
|---|---|
| Pages | 32(3): e322-e337 |
| DOIs | |
| Publication status | Published - 1 May 2022 |