BackgroundInjury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies.AimTo determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures.MethodsIn a cluster-randomised controlled trial, 40 independent schools (118 teams, 3188 players aged 14–18 years) were allocated to receive either the intervention or a reference programme, 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 manoeuvres. Time-loss (>24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff.Results441 time-loss match injuries (intervention, 233; control, 208) were reported across 15 938 match exposure-hours (intervention, 9083; control, 6855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR)=0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR=0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR=0.28, 0.14 to 0.51) and concussion incidence (RR=0.41, 0.17 to 0.99) were noted in the intervention group.ConclusionA preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week.

The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement’s themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities. This document summarises the approaches discussed by medical representatives from the governing bodies of 10 different contact and collision sports in Dublin, Ireland in July 2017. Those sports are: American football, Australian football, basketball, cricket, equestrian sports, football/soccer, ice hockey, rugby league, rugby union and skiing. This document had been endorsed by 11 sport governing bodies/national federations at the time of being published.

Rugby union (RU) is a skill-collision team sport played at junior and senior levels worldwide. Within England, agegrade rugby governs the participation and talent development of youth players. The RU player development pathway has recently been questioned, regarding player performance and well-being, which sport science research can address. The purpose of this review was to summarise and critically appraise the literature in relation to the applied sport science of male age-grade RU players in England focussing upon (1) match-play characteristics, (2) training exposures, (3) physical qualities, (4) fatigue and recovery, (5) nutrition, (6) psychological challenges and development, and (7) injury. Current research evidence suggests that age, playing level and position influence the match-play characteristics of age-grade RU. Training exposures of players are described as 'organised chaos' due to the multiple environments and stakeholders involved in coordinating training schedules. Fatigue is apparent up to 72 h post match-play. Well-developed physical qualities are important for player development and injury risk reduction. The nutritional requirements are high due to the energetic costs of collisions. Concerns around the psychological characteristics have also been identified (e.g. perfectionism). Injury risk is an important consideration with prevention strategies available. This review highlights the important multi-disciplinary aspects of sport science for developing age-grade RU players for continued participation and player development. The review describes where some current practices may not be optimal, provides a framework to assist practitioners to effectively prepare age-grade players for the holistic demands of youth RU and considers areas for future research. Key PointsAge, playing level and position influence the matchplay characteristics and training exposure of agegrade RU players within England. Coaches and administrators should understand the complexity of match-play and training within age-grade RU and carefully plan and schedule competition and training to optimise long-term player development and participation within the sport. A broad range of physical qualities including body size, speed, change of direction speed, high-intensity running ability and muscular strength and power are important for player development alongside injury prevention and should be strongly considered within the programmes of age-grade RU players. The consideration of training exposure, fatigue and recovery, physical development, nutrition, psychological development and injury management are key topics that inform coach and key stakeholders education for maximising participation and long-term player development of age-grade RU players.

BackgroundInjuries to youth rugby players have become an increasingly prominent health concern, highlighting the importance of developing and implementing appropriate preventive strategies. A growing body of evidence from other youth sports has demonstrated the efficacy of targeted exercise regimens to reduce injury risk. However, studies have yet to investigate the effect of such interventions in youth contact sport populations like rugby union.ObjectiveTo determine the efficacy of an evidence-based movement control exercise programme compared with a sham exercise programme to reduce injury risk in youth rugby players. Exercise programme compliance between trial arms and the effect of coach attitudes on compliance will also be evaluated.SettingSchool rugby coaches in England will be the target of the researcher intervention, with the effects of the injury prevention programmes being measured in male youth players aged 14–18 years in school rugby programmes over the 2015–2016 school winter term.MethodsA cluster-randomised controlled trial with schools randomly allocated to either a movement control exercise programme or a sham exercise programme, both of which are coach-delivered. Injury measures will derive from field-based injury surveillance, with match and training exposure and compliance recorded. A questionnaire will be used to evaluate coach attitudes, knowledge, beliefs and behaviours both prior to and on the conclusion of the study period.Outcome measuresSummary injury measures (incidence, severity and burden) will be compared between trial arms, as will the influence of coach attitudes on compliance and injury burden. Additionally, changes in these outcomes through using the exercise programmes will be evaluated.Trial registration numberISRTCNN13422001.

Three of the authors (RT, EF, MH) are full-time and part-time employed by World Rugby in roles of research and medicine. JP and GF have served as independent advisors on a working group on concussion administered by World Rugby, for which expenses are covered. Ethics approval and consent to participateThe research plan for this study was approved by the World Rugby Institutional Ethics committee (REF 19007). Players had provided written informed consent for all data gathered as part of the World Rugby Concussion management programme to be used for research in a de-identified manner Availability of data and materialOriginal participant data belongs to the players and the clubs/unions that generate such data. This may be provided upon request to third parties. World Rugby (the corresponding author) may facilitate the provision of that data, in terms of permissions and contacts, though there is not a single point of contact, since the data are generated globally from multiple teams and Unions. Author' contributions and declarationMR conceived the study. MR, RT and EF designed the study. RT and MH performed the analyses. All authors made substantial contributions to the study design, data processing and interpretation. RT drafted the article and all other authors revised it critically for important intellectual content. RT is the guarantor. All authors had full access to all of the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The manuscript has not been published elsewhere and is not being considered for publication elsewhere.