The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial

Hislop, Michael; Stokes, Keith; Williams, Seán; McKay, Carly; England, Mike; Kemp, Simon; Trewartha, Grant

doi:10.1136/bmjsem-2015-000043

Cited by 22 publications

(18 citation statements)

References 121 publications

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“…The efficacy of the intervention reflects reductions in musculoskeletal injury and concussion found in schoolboy rugby 40 using a similar intervention. 41 A cluster randomised controlled trial reduces biases associated with the results and the pragmatic, coach (delivery agent)-led delivery approach increased the generalisability of the study results. This coach-led, club-based warm-up intervention programme, which included balance and proprioception exercises, resistance and perturbation exercises and sport-related landing, cutting and plyometric exercises, is efficacious in reducing overall targeted injury and severe injury in adult men’s community rugby and should be implemented nationwide.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

et al. 2017

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BackgroundExercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking.ObjectiveTo evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players.Methods856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries.ResultsPoisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).ConclusionsThe movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

et al. 2017

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“…Adding even more levels of exercises and providing further examples for progression to make it fit both children and senior players, as suggested by the coaches, would probably also facilitate long‐term use and make the transition from junior to senior levels better in terms of injury prevention. In a study in youth rugby, the complexity of exercises was adapted to fit different age‐groups to make sure the exercises offered training stimulus for all teams . Tailoring by offering more variation, progression, and possibilities for individualization has also been suggested in a study of professional male youth football players using the FIFA 11+ .…”

Section: Discussionmentioning

confidence: 99%

Adoption and use of an injury prevention exercise program in female football: A qualitative study among coaches

Lindblom

Carlfjord

Hägglund

2017

Scandinavian Med Sci Sports

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This study focuses on an injury prevention exercise program (IPEP), Knee Control, which has been shown to reduce the incidence of acute knee injury in female adolescent football players. The aim was to explore the factors influencing coaches' adoption and use of Knee Control within female football in Sweden. This was a qualitative study involving interviews with 20 strategically selected coaches for female football teams, predominantly adolescent teams. The semi-structured interview guide was influenced by the Health Belief Model, and an ecological perspective was adopted during the interviews. Interviews were analyzed with qualitative content analysis. The results illustrate the different influences that interact on adoption and use of Knee Control by coaches. The coaches described themselves as crucial for Knee Control adoption and use, but external facilitators and barriers such as resources for training, social support from other coaches, clubs and football associations and player buy-in were also described as important. Knee Control characteristics, such as how well the program fit the team, also influenced use of Knee Control. Many coaches modified the program to improve player buy-in and Knee Control fit. Such modifications may risk compromising the preventive effect but may increase feasibility, that is the ease of using Knee Control, and thereby long-term use. These findings may guide the design and delivery of future IPEPs, and improve use of Knee Control, for example, by expanding the program to fit different target groups and supporting coaches and players in the use of Knee Control.

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“…In addition, a recent letter published in the British Medical Journal has outlined the efforts of conducting injury surveillance studies in the community game in England36 and separately37 highlighted the ongoing injury surveillance and injury intervention strategies that are currently being undertaken in schoolboy Rugby Union. Injury prevention programmes such as BokSmart in South Africa5 and the RugbySmart programme in New Zealand offer intervention strategies that have been shown to reduce serious injury incidence.…”

Section: Reducing Risk In Rugby Union: Unknown Variables and Potentiamentioning

confidence: 99%

Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review

2016

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It has recently been proposed that the tackle, an integral part of Rugby Union, be banned in school rugby, as a means to reduce the risk of injury. This proposal held that harmful contact should be removed in response to what was termed an unacceptably high-injury risk. Such a ban would represent a significant intervention that could change the nature of Rugby Union. As such, the basis and rationale for such a ban is worthy of critical evaluation. This review aims to describe the research on which such a ban is proposed. It does so through an assessment (identification), estimation (understanding of the magnitude and occurrence) and evaluation (determining acceptability) of the risk before decisions can be made about implementing any risk mitigation strategies. The body of literature describing injury risk, particularly among youths, is indeed thin and fraught with methodological differences that makes definitive conclusions impossible. We describe these, and their implications, arguing that the complete ban on the tackle may be unnecessary in young children, in whom injury risk may not be as high as is often argued, but also that it may have detrimental consequences. Finally, we propose alternative strategies and research questions which must be pursued to effectively reduce risk without creating unintended consequences or changing the nature of the sport.

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The efficacy of a movement control exercise programme to reduce injuries in youth rugby: a cluster randomised controlled trial

Cited by 22 publications

References 121 publications

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

Adoption and use of an injury prevention exercise program in female football: A qualitative study among coaches

Injury risk and a tackle ban in youth Rugby Union: reviewing the evidence and searching for targeted, effective interventions. A critical review

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