Incidence and Risk Factors in Concussion Events: A 5-Season Study in the French Top 14 Rugby Union Championship

Abstract

Background: Concussions are a source of major concern in rugby, and a limited number of studies have attempted to identify risk factors for these injuries. Purpose: To investigate the incidence of match concussion and associated risk factors, including individual workload, anthropometric variables, playing position, and season phase, in elite rugby union players. Study Design: Case-control study; Level of evidence 3. Methods: All concussions and explanatory variables were collected for every match over 5 consecutive seasons (2014-2018) in 1334 professional players participating in the French Top 14 championship. Concussion risk was estimated using mixed effects Poisson regression. Results: Mean match concussion incidence equated to 10.4 (95% CI, 9.3-11.5) concussions for 1000 hours of game exposure. A peak was reached in the 2016-2017 season (13.7; 95% CI, 11.0-16.5). A greater risk was observed in the playoffs as compared with the first phase of the season (incidence rate ratio, 3.96; 95% CI, 2.10-7.35). In comparison with other positions, half-backs incurred the highest rate of concussion events (incidence, 16.1; 95% CI, 11.8-20.3). Irrespective of playing position, those with greater height and lower body mass reported a higher risk of concussions ( P = .02), especially during tackling actions for lighter players ( P = .01) and during other match events for taller players ( P = .03). When adjusted for season phase, players who had accumulated a higher amount of playing time since the beginning of the season demonstrated a lower risk of concussion ( P = .005). Conclusion: Inter- and intraseasonal variations in concussion rates were observed. Within positional groups, lighter and taller players were more at risk, with the highest incidence generally observed in half-backs. Workload was measured by the number of matches played before a concussion event, and it appeared to have a protective rather than deleterious effect on concussion risk.

Risk Factors for Concussion in Under 18, Under 22 and Professional Men's Rugby Union: A Video Analysis of 14,809 Tackles

“…The incidence rate of concussion was greater in Elite players than U18 or U22 players, which was consistent with the findings in other studies [ 7 – 9 , 21 ]. It is likely due to the greater momentum gained by heavier, taller players with high speed.…”

“…Recent studies reported that a tackle event is the most common cause of concussion, and 70% of tackle-related concussions occur in the tacklers [ 1 , 4 , 5 ]. Detailed analysis of tackles using video footage has become a standard method for investigating the cause of the injuries [ 4 – 9 ], and analyzing the body position and height of the tackle may be of value for reducing tackle-related concussion [ 1 , 4 , 5 , 10 – 17 ].…”