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

ABSTRACT: Exercise 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.To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players.856 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.Poisson 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).The 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.

SUBMITTER: Attwood MJ

PROVIDER: S-EPMC5867421 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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

Attwood Matthew J MJ Roberts Simon P SP Trewartha Grant G England Mike E ME Stokes Keith A KA

British journal of sports medicine 20171021 6

<h4>Background</h4>Exercise 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.<h4>Objective</h4>To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players.<h4>Methods</h4>856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled t ...[more]

PMID: 29055883

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Project description:This study compared the movement demands of elite international Under-20 age grade (U20s) and senior international rugby union players during competitive tournament match play. Forty elite professional players from an U20 and 27 elite professional senior players from international performance squads were monitored using 10Hz global positioning systems (GPS) during 15 (U20s) and 8 (senior) international tournament matches during the 2014 and 2015 seasons. Data on distances, velocities, accelerations, decelerations, high metabolic load (HML) distance and efforts, and number of sprints were derived. Data files from players who played over 60 min (n = 258) were separated firstly into Forwards and Backs, and more specifically into six positional groups; FR-Front Row (prop & hooker), SR-Second Row, BR-Back Row (Flankers & No.8), HB-Half Backs (scrum half & outside half), MF-Midfield (centres), B3 -Back Three (wings & full back) for match analysis. Linear mixed models revealed significant differences between U20 and senior teams in both the forwards and backs. In the forwards the seniors covered greater HML distance (736.4 ± 280.3 vs 701.3 ± 198.7m, p = 0.01) and severe decelerations (2.38 ± 2.2 vs 2.28 ± 1.65, p = 0.05) compared to the U20s, but performed less relative HSR (3.1 ± 1.6 vs 3.2 ± 1.5, p < 0.01), moderate (19.4 ± 10.5 vs 23.6 ± 10.5, p = 0.01) and high accelerations (2.2 ± 1.9 vs 4.3 ± 2.7, p < 0.01) and sprint•min-1 (0.11 ± 0.06 vs 0.11 ± 0.05, p < 0.01). Senior backs covered a greater relative distance (73.3 ± 8.1 vs 69.1 ± 7.6 m•min-1, p < 0.01), greater High Metabolic Load (HML) distance (1138.0 ± 233.5 vs 1060.4 ± 218.1m, p < 0.01), HML efforts (112.7 ± 22.2 vs 98.8 ± 21.7, p < 0.01) and heavy decelerations (9.9 ± 4.3 vs 9.5 ± 4.4, p = 0.04) than the U20s backs. However, the U20s backs performed more relative HSR (7.3 ± 2.1 vs 7.2 ± 2.1, p <0.01) and sprint•min-1 (0.26 ± 0.07 vs 0.25 ± 0.07, p < 0.01). Further investigation highlighted differences between the 6 positional groups of the teams. The positional groups that differed the most on the variables measured were the FR and MF groups, with the U20s FR having higher outputs on HSR, moderate & high accelerations, moderate, high & severe decelerations, HML distance, HML efforts, and sprints•min-1. For the MF group the senior players produced greater values for relative distance covered, HSR, moderate decelerations, HML distance and sprint•min-1. The BR position group was most similar with the only differences seen on heavy accelerations (U20s higher) and moderate decelerations (seniors higher). Findings demonstrate that U20s internationals appear to be an adequate 'stepping stone' for preparing players for movement characteristics found senior International rugby, however, the current study highlight for the first time that certain positional groups may require more time to be able to match the movement demands required at a higher playing level than others. Conditioning staff must also bear in mind that the U20s players whilst maintaining or improving match movement capabilities may require to gain substantial mass in some positions to match their senior counterparts.

Project description:OBJECTIVES:To assess the effectiveness of a combined classroom curriculum and parental intervention (the Steps Towards Alcohol Misuse Prevention Programme (STAMPP)), compared with alcohol education as normal (EAN), in reducing self-reported heavy episodic drinking (HED) and alcohol-related harms (ARHs) in adolescents. SETTING:105 high schools in Northern Ireland (NI) and in Scotland. PARTICIPANTS:Schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational). Eligible students were in school year 8/S1 (aged 11-12 years) at baseline (June 2012). INTERVENTION:A classroom-based alcohol education intervention, coupled with a brief alcohol intervention for parents/carers. PRIMARY OUTCOMES: (1) The prevalence of self-reported HED in the previous 30 days and (2) the number of self-reported ARHs in the previous 6?months. Outcomes were assessed using two-level random intercepts models (logistic regression for HED and negative binomial for number of ARHs). RESULTS:At 33 months, data were available for 5160 intervention and 5073 control students (HED outcome), and 5234 and 5146 students (ARH outcome), respectively. Of those who completed a questionnaire at either baseline or 12 months (n=12?738), 10?405 also completed the questionnaire at 33 months (81.7%). Fewer students in the intervention group reported HED compared with EAN (17%vs26%; OR=0.60, 95%?CI 0.49 to 0.73), with no significant difference in the number of self-reported ARHs (incident rate ratio=0.92, 95% CI 0.78 to 1.05). Although the classroom component was largely delivered as intended, there was low uptake of the parental component. There were no reported adverse effects. CONCLUSIONS:Results suggest that STAMPP could be an effective programme to reduce HED prevalence. While there was no significant reduction in ARH, it is plausible that effects on harms would manifest later. TRIAL REGISTRATION NUMBER:ISRCTN47028486; Post-results.

Project description:BackgroundCollisions in rugby union and sevens have a high injury incidence and burden, and are also associated with player and team performance. Understanding the frequency and intensity of these collisions is therefore important for coaches and practitioners to adequately prepare players for competition. The aim of this review is to synthesise the current literature to provide a summary of the collision frequencies and intensities for rugby union and rugby sevens based on video-based analysis and microtechnology.MethodsA systematic search using key words was done on four different databases from 1 January 1990 to 1 September 2021 (PubMed, Scopus, SPORTDiscus and Web of Science).ResultsSeventy-three studies were included in the final review, with fifty-eight studies focusing on rugby union, while fifteen studies explored rugby sevens. Of the included studies, four focused on training-three in rugby union and one in sevens, two focused on both training and match-play in rugby union and one in rugby sevens, while the remaining sixty-six studies explored collisions from match-play. The studies included, provincial, national, international, professional, experienced, novice and collegiate players. Most of the studies used video-based analysis (n = 37) to quantify collisions. In rugby union, on average a total of 22.0 (19.0-25.0) scrums, 116.2 (62.7-169.7) rucks, and 156.1 (121.2-191.0) tackles occur per match. In sevens, on average 1.8 (1.7-2.0) scrums, 4.8 (0-11.8) rucks and 14.1 (0-32.8) tackles occur per match.ConclusionsThis review showed more studies quantified collisions in matches compared to training. To ensure athletes are adequately prepared for match collision loads, training should be prescribed to meet the match demands. Per minute, rugby sevens players perform more tackles and ball carries into contact than rugby union players and forwards experienced more impacts and tackles than backs. Forwards also perform more very heavy impacts and severe impacts than backs in rugby union. To improve the relationship between matches and training, integrating both video-based analysis and microtechnology is recommended. The frequency and intensity of collisions in training and matches may lead to adaptations for a "collision-fit" player and lend itself to general training principles such as periodisation for optimum collision adaptation. Trial Registration PROSPERO registration number: CRD42020191112.

Dataset Information

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

Publications

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

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