Tackling concussion in professional rugby union: a case-control study of tackle-based risk factors and recommendations for primary prevention.


Journal

British journal of sports medicine
ISSN: 1473-0480
Titre abrégé: Br J Sports Med
Pays: England
ID NLM: 0432520

Informations de publication

Date de publication:
Aug 2019
Historique:
accepted: 12 09 2017
pubmed: 13 10 2017
medline: 29 10 2019
entrez: 13 10 2017
Statut: ppublish

Résumé

Concussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion. 182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional rugby union competitions. A variable selection process was undertaken to identify the most important variables for interpretation. A multivariate generalised linear model was used to model the association between retained variables and concussion risk. Magnitude-based inferences provided an interpretation of the real-world relevance of the outcomes. The four retained variables were: accelerating player, tackler speed, head contact type and tackle type. Overall, 70% of concussions occurred to the tackler and 30% to the ball carrier. There was a higher risk of concussion if the tackler accelerated into the tackle (OR: 2.49, 95% CI 1.70 to 3.64) or the tackler was moving at high speed (OR: 2.64, 95% CI 1.92 to 3.63). Head contact with the opposing player's head (OR: 39.9, 95% CI 22.2 to 71.1) resulted in a substantially greater risk of concussion compared with all other head contact locations. Interventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Concussion, the most common injury in professional rugby union, occurs most commonly during the tackle. Thus, we investigated the association between tackle characteristics and concussion.
METHODS METHODS
182 video clips of tackles leading to clinically diagnosed concussion and 4619 tackles that did not were coded across three professional rugby union competitions. A variable selection process was undertaken to identify the most important variables for interpretation. A multivariate generalised linear model was used to model the association between retained variables and concussion risk. Magnitude-based inferences provided an interpretation of the real-world relevance of the outcomes.
RESULTS RESULTS
The four retained variables were: accelerating player, tackler speed, head contact type and tackle type. Overall, 70% of concussions occurred to the tackler and 30% to the ball carrier. There was a higher risk of concussion if the tackler accelerated into the tackle (OR: 2.49, 95% CI 1.70 to 3.64) or the tackler was moving at high speed (OR: 2.64, 95% CI 1.92 to 3.63). Head contact with the opposing player's head (OR: 39.9, 95% CI 22.2 to 71.1) resulted in a substantially greater risk of concussion compared with all other head contact locations.
CONCLUSIONS CONCLUSIONS
Interventions that reduce the speed and acceleration of the tackler and reduce exposure to head-to-head contact would likely reduce concussion risk in professional rugby union.

Identifiants

pubmed: 29021244
pii: bjsports-2017-097912
doi: 10.1136/bjsports-2017-097912
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1021-1025

Informations de copyright

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Déclaration de conflit d'intérêts

Competing interests: MJC and SK are employed by the Rugby Football Union. MR, BH and RT are employed by World Rugby. CR and PM are employed by the Welsh Rugby Union and have previously received research funding from World Rugby. SW and KAS are employed by the University of Bath and have previously received research funding from the Rugby Football Union.

Auteurs

Matthew J Cross (MJ)

Professional Rugby Department, Rugby Football Union, Twickenham, London, UK.
Department for Health, University of Bath, Bath, UK.

Ross Tucker (R)

World Rugby, Dublin, Ireland.

Martin Raftery (M)

World Rugby, Dublin, Ireland.

Ben Hester (B)

World Rugby, Dublin, Ireland.

Sean Williams (S)

Department for Health, University of Bath, Bath, UK.

Keith A Stokes (KA)

Department for Health, University of Bath, Bath, UK.

Craig Ranson (C)

Sports Injury Research Group, Cardiff Metropolitan University, Cardiff, UK.
Welsh Rugby Union, Cardiff, UK.

Prav Mathema (P)

Welsh Rugby Union, Cardiff, UK.

Simon Kemp (S)

Professional Rugby Department, Rugby Football Union, Twickenham, London, UK.

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