Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial

Intro: Musculoskeletal injuries and concussion are prominent reasons for time loss from sport for adolescent rugby players.

Injury patterns in rugby differ from other team sports, 

-Greater frequency of concussion, upper body and contact-related injuries

Increased concussion risk is associated with lower neck strength, highlighting this characteristic as a potentially modifiable risk factor.

Enhancing neck muscle strength may prevent concussion by improving the dissipation of impact forces transmitted to the brain.

The aim of study was to determine the efficacy of a movement control exercise program in reducing injuries in youth rugby players.

Methods: In a cluster-randomized controlled trial, 40 independent schools (118 teams, 3188 players aged 14-18 years) were allocated to receive either the intervention or a reference program, both of which were to be delivered by school coaches. 

The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting maneuvers. This also included a neck strengthening component. 

Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff.

Results: When trial arm comparisons were limited to teams who had completed three or more weekly program sessions on average, clear reductions in overall match injury incidence (RR=0.28) and concussion incidence (RR=0.41) were noted in the intervention group.

• NMT inclusive of a neck strengthening component was associated with a 59% lower sport related concussion rate.
• Completing the intervention program 3 times per week led to substantial reductions of 72% in overall match injury incidence and 72% in contact-related injury incidence compared with the control program.

Conclusion:

• These findings provide encouraging evidence that a pre-activity preventive exercise program can substantially reduce injury risk in youth rugby, specifically a reduction in sport related concussion.

References

Hislop MD, et al. Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial. Br J Sports Med. 2017 Aug;51(15):1140-1146.