The Incidence, Cost, and Burden of Concussion in Women’s Rugby League and Rugby Union: A Systematic Review and Pooled Analysis

Abstract

Background The extent of concussion injury in the rugby codes for women is unclear. Objective Our aim was to review all published studies reporting concussion injuries from match and training participation in rugby codes and report the pooled data estimates for rugby league and union concussion injury epidemiology. Methods We conducted a systematic literature analysis of concussion in rugby league and rugby union for published studies from January 1990 to July 2021. Data from 16 studies meeting the inclusion criteria were extracted for women’s concussion injuries and were subsequently pooled. Costs from Accident Compensation Corporation (ACC) data were attributed to the results to provide cost estimates. Results The pooled analysis match injury incidence of women’s concussion was higher for rugby league (10.3 per 1000 match hours) than rugby 15 s (2.8 per 1000 match hours) or rugby 7 s (8.9 per 1000 match hours). There was a fourfold difference in the pooled incidence of concussion in women’s rugby league (risk ratio [RR] 4.53, 95% confidence interval [CI] 1.8–11.3]; p = 0.0001) when compared with rugby 15 s. There was also a ninefold higher risk of a concussion during match participation compared with training participation for women’s rugby 15 s (RR 9.3, 95% CI 1.29–66.78; p = 0.0070). The total estimated costs for the concussions reported were NZ$1,235,101. For rugby 7 s, the pooled concussive injury burden was 33.2 days. Conclusions Our pooled analysis clarified the extent of concussion injury and the possible associated costs at several levels of the game for women’s rugby codes. The pooled mean days lost because of concussions was 33 days. As this was considerably longer than the 7- to 10-day expected timeframe outlined in the Concussion in Sport Consensus statement, these guidelines need to be updated to include sex-specific differences.

More than rugby: A scoping review of coaches in rugby

“…Forty-four of these studies reported male coaches (n = 44), 36,46,50,51,53,56,62,66-68,71,73,76,80,89,92-97, 99-101,103-105,107-110,112,115,117-121,123-126,128 only three (n = 3) studies reported female coaches and 18 studies (n = 18) reported both male and female coaches in their studies. 29,32,35,38,39,55,57,58,60,65,70,72,84,87,90,113,114,130 Most of the studies focused on coaches within rugby union (n = 80, 76%) 18,29-42,44-55,57,58,61,63,69,70,73-80,82-90, 92-95,99-110,112,115-117,119,120,123,124,126-129,131 and rugby league (n = 14, 14%). 43,56,59,60,62,64,[66][67][68]71,81,91,121,125 The remainder of the studies focused on a combination of rugby cohorts (n = 4, 4%), [96][97][98]114 and only one study focused on rugby sevens (n = 1, 1%).…”

“…29,32,35,38,39,55,57,58,60,65,70,72,84,87,90,113,114,130 Most of the studies focused on coaches within rugby union (n = 80, 76%) 18,29-42,44-55,57,58,61,63,69,70,73-80,82-90, 92-95,99-110,112,115-117,119,120,123,124,126-129,131 and rugby league (n = 14, 14%). 43,56,59,60,62,64,[66][67][68]71,81,91,121,125 The remainder of the studies focused on a combination of rugby cohorts (n = 4, 4%), [96][97][98]114 and only one study focused on rugby sevens (n = 1, 1%). 111 Five studies did not specify the type of rugby (n = 5, 5%).…”

Sport-related concussion disclosure in women's rugby—A social identity approach

“…It is the responsibility of all key stakeholders involved in the rugby union to ensure that increased female participation does not come at an increased risk to the wellbeing of the players. Strategies to prioritise athlete health and reduce the risk of serious injury, such as sport-related concussions (SRCs) ( 3 , 4 ), must be addressed to avoid a concurrent increase in risk of injury, as participation in women's rugby increases.…”

“…Collision sports, such as rugby, represent a high degree of risk for SRCs. A systematic review by King et al ( 3 ) highlighted that the incidence rate of SRC was 2.8 per 1,000 h of match play for women's rugby-15s and 8.9 per 1,000 h of match play for women's rugby-7s. Table 1 highlights the available data for the injury rate and incidence of SRC in women's rugby.…”

A Global Women’s Rugby Union Web-Based Survey

“…In women’s rugby, concussions are one of the most common injuries, carrying a significant injury burden [ 11 , 12 ]. There is evidence that female athletes are 2.6 times more likely than males to suffer a concussion in sport [ 13 , 14 , 15 ], with a more severe and prolonged symptom burden [ 16 , 17 ].…”