Due to the nature of rugby, concussions are a frequent occurrence and can go undetected by different stakeholders. Knowledge regarding identification of symptoms, management and prevention of re-injury is crucial for the welfare of players. The aim of the study was to determine the concussion knowledge and attitudes among different community club rugby stakeholders. The study gathered quantitative information by utilizing the Rosenbaum Concussion Knowledge and Attitude Survey-Student Version (RoCKAS-ST). Of all the participants (N = 434), medical staff (79 ± 10%) provided the highest Concussion Knowledge Index scores followed by referees (78 ± 8%) and players (67 ± 13%). The stakeholders scored 76% overall for Concussion Attitude Index. Across the scenarios the different participants believed to have safer attitudes compared to that of others within their team. Statistical differences were found between stakeholders when asked if concussion is less important than other injuries, as players, coaches and administrative staff all indicated an unsafe response in contrast to that of referees (p < 0.01). Players indicated an unsafe attitude towards returning to play, while symptomatic as a result of a concussion whereas coaches indicated a safer response (p < 0.01). Only two out of eight legitimate symptoms, headaches and dizziness, were correctly identified by 80% or more of participants, which warrants concern that identification of symptoms could be lacking on this level. Investigating the knowledge and attitudes of concussion at community club rugby level could identify which areas are to be further targeted by the South African Rugby Union.

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Concussion is a frequently occurring injury in rugby which is not usually reported to coaches or medical staff. Recognition and treatment of concussion should be a priority; however, education surrounding concussion knowledge and attitudes of the players have been lacking. The aim of this study was to investigate the knowledge and attitudes toward concussion in Western Province Rugby Union (WPRU) Super League senior club rugby players. This study focused on gathering quantitative information from WPRU club rugby players, using the Rosenbaum Concussion Knowledge and Attitudes Survey-Student Version (RoCKAS-ST). The correlation between the Concussion Attitude Index (CAI) and Concussion Knowledge Index (CKI) was (r=0.14). The CKI average for the players was (16.72±2.96). The participants answered 67% (16.72±2.96) of the CKI questions and 62% (46.54±5.75) of the CAI questions correctly. The participants demonstrated sufficient knowledge of concussion, as well as safe attitudes toward concussion. A small number of players lacked knowledge of symptoms and attitudes toward concussion, which may have been influenced by the importance of games. Overall, the participants in this study demonstrated superior knowledge and safe attitudes compared to other studies. The current study found that the players had good knowledge and safe attitudes regarding the severity of concussion.

Concussions are an inherent part of rugby; however, subsequent concussions can be decreased by following the appropriate post-concussion return-to-play (RTP) protocols. The aim of this study was to compare stakeholders’ perceptions regarding their roles and responsibilities in terms of the implementation of post-concussion RTP in community club rugby in the Western Cape, South Africa. The results of a post-concussion RTP implementation questionnaire revealed limited knowledge of the recommended 6-stage BokSmart™ RTP protocol among players. Although not essential that players have knowledge of this protocol, this can be indicative of coaches’ disregard of the importance of communicating concussion knowledge. Coaches were identified as having a major role to play in post-concussion RTP, being responsible for monitoring matches and training sessions for concussion. They were also considered the most knowledgeable stakeholders on post-concussion return-to-play guidelines. Yet, coaches and administrative staff demonstrated a relatively low ability to advise on when to safely return to play. Only two thirds of coaches and a third of administrative staff were found to implement the recommended protocol, while less than half of medical staff and only a third of coaches demonstrated the ability to implement the protocol correctly, revealing inadequate knowledge. Hence, the study underscored the significance of education focusing on the practical implementation of post-concussion RTP protocols within community club rugby.