Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies

Abstract

Article:Tucker, R., Raftery, M., Kemp, S. et ReuseUnless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Risk factors for head injury events in professional Rugby AbstractObjectives: The tackle is responsible for the majority of head injuries during Rugby Union. In order to address head injury risk, risk factors during the tackle must first be identified. This study analysed tackle characteristics in the professional game in order to inform potential interventions. Methods: 464 tackles resulting in a head injury assessment (HIA) were analysed in detail, with tackle type, direction, speed, acceleration, nature of head contact and player body position the characteristics of interest. Results: Propensity to cause an HIA was significantly greater for active shoulder tackles, front-on tackles, high speeder tackles and an accelerating tackler. Head contact between a tackler's head and ball carrier's head or shoulder was significantly more likely to cause an HIA than contact below the level of the shoulder (IRR 4.25,). The tackler experiences the majority (78%) of HIAs when head-to-head contact occurs. An upright tackler was 1.5 times more likely to experience an HIA than a bent at the waist tackler (IRR 1.44, CI 1.18 -1.76). Conclusions: This study confirms that energy transfer in the tackle is a risk factor for head injury, since direction, type and speed all influence HIA propensity. The study provides evidence that body position and the height of tackles should be a focus for interventions, since lowering height and adopting a bent at the waist body position is associated with reduced risk for both tacklers and ball carriers. To this end, World Rugby have implemented law change based on the present data. WHAT DOES THIS STUDY ADD? This study is the largest to date to decribe risk factors for head injuries requiring a head injury assessment in professional rugby union, using a cohort of 464 head injury events over three years  The tackler more likely to sustain head injuries than the ball carrier  Energy transfer is a risk factor for head injury, since active shoulder, front on, high speed and acceleration into tackles were more likely to cause head injuries  We find that higher impacts are more than four times more likely to result in head injury. Tack...

Characteristics and factors of concussion events for tacklers in collegiate rugby union

“…The chances of a concussion were decreased when the tackler did not move before the tackle event; this result is in line with those of previous studies. 6,10 The risk of concussions 6 and the propensity to cause an HIA 10 were significantly greater among tacklers moving at higher speeds or accelerating. Therefore, we recommend that tacklers control their speed in the pre-contact phase, which results in a tackle characteristic that lowers the risk of concussions at the moment of contact.…”

“…[3][4][5] Recently, in rugby union, research on the inciting events leading to concussion and head injury assessment (HIA) has increased, 6-10 with a particular focus on tackling situations. 6,[8][9][10] The aforementioned studies assessed professional rugby union players, and it is considered that the results are unlikely to be applicable to nonprofessional cohorts included both youth and community cohorts. 6,9,10 Furthermore, since the HIA is applied to the only professional level, it is easily possible to collect the concussion data and video records compared with community level.…”

Lay of the land: narrative synthesis of tackle research in rugby union and rugby sevens

“…Certain studies also focused on niche areas including head injuries and concussions, 31 40 53-70 spinal and neck injuries, [71][72][73][74][75][76][77][78][79] shoulder injuries, 34 80-88 knee and ankle injuries, [89][90][91][92][93] and the influence of tackle technique on injuries. 61 64 65 69 94-96 Overall and time-loss injury frequencies and rates for rugby union (tables 1 and 2) and sevens (table 3) were tabulated (all injury types included). Tackle-related injury case studies were also summarised for all levels of rugby union and sevens from 1995 to 2018 (see online supplementary appendix 1).…”

Video analysis of tackling situations leading to concussion in collegiate rugby union

“…Research on inciting events leading to concussion and HIA with video records has progressed rapidly in recent years [14][15][16][17] . Previous research, targeting the European professional level, suggested there was a higher risk of concussion when the tackler accelerated into a tackle or had head contact with the ball-carrier's head 14,17) . Sobue et al showed that concussion occurred significantly more often during tackles with incorrect head positioning (i.e.…”