Preventing spinal cord injuries in rugby union

Noakes, Timothy D.; Draper, Catherine E.

doi:10.1136/bmj.39156.483634.80

Cited by 16 publications

(8 citation statements)

References 9 publications

(2 reference statements)

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“…9 10 11 Based on this success, the South African Rugby Union (SARU) developed their own programme, BokSmart (http://www.boksmart.com),12 13 modelling it on a comparable intervention approach to New Zealand with additional components to suit the South African rugby landscape, making it an example of a national sports organisation intervention 14. Other catastrophic injury prevention strategies for rugby include Rugbyready (International Rugby Board (IRB)), Smart Rugby (Australia) and Tackling Safety (England) 1.…”

Section: Introductionmentioning

confidence: 99%

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

et al. 2013

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ObjectivesTo establish an accurate and comprehensive injury incidence registry of all rugby union-related catastrophic events in South Africa between 2008 and 2011. An additional aim was to investigate correlates associated with these injuries.DesignProspective.SettingThe South African amateur and professional rugby-playing population.ParticipantsAn estimated 529 483 Junior and 121 663 Senior rugby union (‘rugby’) players (population at risk).Outcome measuresAnnual average incidences of rugby-related catastrophic injuries by type (cardiac events, traumatic brain and acute spinal cord injuries (ASCIs)) and outcome (full recoveries—fatalities). Playing level (junior and senior levels), position and event (phase of play) were also assessed.ResultsThe average annual incidence of ASCIs and Traumatic Brain Injuries combined was 2.00 per 100 000 players (95% CI 0.91 to 3.08) from 2008 to 2011. The incidence of ASCIs with permanent outcomes was significantly higher at the Senior level (4.52 per 100 000 players, 95% CI 0.74 to 8.30) than the Junior level (0.24 per 100 000 players, 95% CI 0 to 0.65) during this period. The hooker position was associated with 46% (n=12 of 26) of all permanent ASCI outcomes, the majority of which (83%) occurred during the scrum phase of play.ConclusionsThe incidence of rugby-related catastrophic injuries in South Africa between 2008 and 2011 is comparable to that of other countries and to most other collision sports. The higher incidence rate of permanent ASCIs at the Senior level could be related to the different law variations or characteristics (eg, less regular training) compared with the Junior level. The hooker and scrum were associated with high proportions of permanent ASCIs. The BokSmart injury prevention programme should focus efforts on these areas (Senior level, hooker and scrum) and use this study as a reference point for the evaluation of the effectiveness of the programme.

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Section: Introductionmentioning

confidence: 99%

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

et al. 2013

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“…The lack of a complete data set for spinal cord injuries in rugby, despite repeated calls over the past 20 years, was highlighted by Noakes and Draper7 in 2007. This survey provided an opportunity to appraise the current state of data collection on catastrophic injuries in the schoolboy game in Great Britain and Ireland.…”

Section: Introductionmentioning

confidence: 99%

Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland

Maclean

Hutchison

2011

Br J Sports Med

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U19 rugby players continue to sustain serious neck injuries necessitating admission to spinal injury units with a low but persistent frequency. The recent rate of admission in Scotland is disproportionately high when the respective estimated playing populations are considered. While more injuries were sustained in the tackle, spinal cord injury was significantly more common in neck injury sustained in the scrum (p<0.001). No register of catastrophic neck injuries exists despite repeated calls over the past three decades, and a study such as this has not been reported before. Data collection of this serious category of injury is incomplete and very variable across the home unions, as a consequence a large proportion of the serious neck injuries that have occurred in U19 players over the past 14 years have not been analysed. Rigorous data collection and analysis have to be established so that problem areas of the game such as scrum engagement and the tackle can be made safer.

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“…The two programs (RugbySmart and BokSmart) have recognizable similarities, such as their program structures which educate coaches and referees in an attempt to prevent catastrophic injuries in players. However, the two countries present very different environments to the implementers of these respective programs (New Zealand Rugby Union and SARU), with South Africa still classified as a “developing nation” with huge socioeconomic disparity among players, coaches, and referees (Noakes & Draper, ). For example, English is only the fourth most spoken language in South Africa (Statistics South Africa, ), yet the BokSmart educational program is taught in this language.…”

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confidence: 99%

The effectiveness of the nationwide BokSmart rugby injury prevention program on catastrophic injury rates

Brown

Verhagen

Knol

et al. 2015

Scandinavian Med Sci Sports

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Rugby Union ("rugby") participants have a higher than average risk of injury compared with participants of other popular team sports. BokSmart, a nationwide injury prevention program was launched in South Africa in mid-2009, with the goal of reducing catastrophic head/neck (serious) injuries in players. The program provides injury prevention information to coaches and referees. This study investigated if BokSmart has been associated with a reduction in these injuries. The BokSmart program collected data on all South African rugby-related serious injuries since 2008. Using a Poisson regression, injury numbers were compared pre-BokSmart (2008-2009) to the years post-implementation (2010-2013). Player numbers were assumed to be constant throughout this evaluation: junior = 529,483; senior = 121,663. In junior players, the "post-BokSmart" period had 2.5 less annual serious injuries than "pre-BokSmart" (incidence rate ratio: 0.6, 95% confidence interval: 0.5-0.7, P < 0.000). In contrast, there was no significant difference in these periods in seniors. The absence of effect in seniors may be a result of fewer players or of differences in effectiveness of BokSmart in this group--future studies should investigate these questions.

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Preventing spinal cord injuries in rugby union

Abstract: Other countries should follow New Zealand's lead

Cited by 16 publications

References 9 publications

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study

Serious neck injuries in U19 rugby union players: an audit of admissions to spinal injury units in Great Britain and Ireland

The effectiveness of the nationwide BokSmart rugby injury prevention program on catastrophic injury rates

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