Concussion-Reporting Behavior in Rugby: A National Survey of Rugby Union Players in the United States

Abstract

Background: Rugby is the fastest growing team sport in the United States for male and female athletes. It is a contact/collision sport with an injury risk profile that includes concussions. Purpose: To examine the prevalence of concussions in male and female rugby players in the United States and to characterize behaviors around reporting concussions that could be a target for prevention and treatment efforts. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An online survey distributed to active members on the USA Rugby membership list was used to examine self-reported concussions in male and female athletes. Concussion-reporting behaviors and return to play after a concussion were also explored. Statistical analysis was used to compare male with female athletes and report differences, with years of experience as a dependent variable. Results: The proportion of athletes with a history of at least 1 concussion was 61.9% in all respondents. Of those who reported a concussion, 50.8% reported the concussion during the game or practice in which it occurred, and 57.6% reported at least 1 concussion to a qualified medical provider. Overall, 27.7% of participants who reported ≥1 rugby-related concussion in our survey noted that at least 1 of these concussions was not formally reported. The most commonly cited reasons for not reporting a concussion included not thinking that it was a serious injury, not knowing that it was a concussion at the time, and not wanting to be pulled out of the game or practice. Additionally, 61.0% of athletes did not engage in recommended return-to-play protocols after their most recent rugby-related concussion. Conclusion: US rugby union athletes may not report concussions to medical personnel or follow return-to-play protocols guided by medical advice. This could result from a lack of education on concussion recognition and the risks associated with continued play after a concussion as well as limited access to health care. Further education efforts focusing on the identification of concussions, removal from play, and return-to-play protocols are necessary in the US rugby union population.

Prevalência de lesões em atletas amadores de rúgbi no Brasil

“…No caso do presente trabalho, houve um equilíbrio entre os dias afastados da prática pela lesão, levando a um número de aproximadamente 85% das lesões levando de 1 a 6 meses de afastamento da prática. O monitoramento de lesões, a acessibilidade ao tratamento médico e fisioterapêutico e a frequência das práticas de prevenção de lesões variam consideravelmente nos diferentes países praticantes conforme o nível de jogo aumenta de amador para profissional (24)(25)(26)(27)(28)(29). Os protocolos de prevenção de lesões futuras devem ser adequados para o uso na rotina do atleta e refletir a organização estrutural do jogo (30,31).…”

Reasons for the Reporting Behavior of Japanese Collegiate Rugby Union Players Regarding Suspected Concussion Symptoms: A Propensity Analysis

“…The questionnaires regarding concussion knowledge, the experience of suspected concussion symptoms, and subsequent behavior were administered to participants using (1) Google Forms or (2) paper and pencil, depending on the resources available in each data-collection situation. The survey lasted 10-15 min based on previous studies [3][4][5]14]. The questionnaire consisted of the following four sections (Appendix A): (1) player profile (age, academic year, and years in RU); (2) knowledge of suspected concussion symptoms;…”

“…Finally, participants responded as to why they reported or did not report suspected concussion symptoms. According to previous studies, the reasons for reporting symptoms were based on the reasons for not reporting [3][4][5]14]. The reasons for reporting behavior were rated on a 5-point Likert scale ranging from 1 (strongly disagree or strongly agree) to 5 (strongly agree or strongly disagree).…”

“…Therefore, some previous studies have focused on whether concussions have been experienced or unreported in RU players. In RU, 25.0-69.0% of players have experienced a concussion [3][4][5][6][7][8][9][10][11][12][13], of which 46.6-52.5% do not report suspected concussion symptoms [5,12]. About half of RU players will continue playing with concussion symptoms.…”

“…RU players do not report concussions for the following three reasons [3][4][5]12]: (1) they do not think the injury is serious; (2) they do not realize it is a concussion; and (3) they do not want to be removed from play. In previous studies of athletes in other sports apart from rugby, the athletes did not report concussions for the same reasons [14][15][16].…”