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Concussion increases within-player injury risk in male professional rugby union

Isabel S Moore Orcid Logo, Charlotte Leah Bitchell Orcid Logo, Danielle Vicary, Jim Rafferty Orcid Logo, Ben Charles Robson, Prabhat Mathema

British Journal of Sports Medicine, Volume: 57, Issue: 7, Pages: bjsports - 2021

Swansea University Author: Jim Rafferty Orcid Logo

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DOI (Published version): 10.1136/bjsports-2021-105238

Abstract

Objectives To assess within-player change in injury risk and between-player subsequent injury risk associated with concussive and common non-concussive injuries in professional rugby union.Methods This prospective cohort study in Welsh professional male rugby union analysed within-player and between...

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Published in: British Journal of Sports Medicine
ISSN: 0306-3674 1473-0480
Published: BMJ 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa62187
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>62187</id><entry>2022-12-19</entry><title>Concussion increases within-player injury risk in male professional rugby union</title><swanseaauthors><author><sid>52effe759a718bd36eb12cdd10fe1a09</sid><ORCID>0000-0002-1667-7265</ORCID><firstname>Jim</firstname><surname>Rafferty</surname><name>Jim Rafferty</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-12-19</date><deptcode>HDAT</deptcode><abstract>Objectives To assess within-player change in injury risk and between-player subsequent injury risk associated with concussive and common non-concussive injuries in professional rugby union.Methods This prospective cohort study in Welsh professional male rugby union analysed within-player and between-player injury risk for five common injuries: concussion, thigh haematoma, hamstring muscle strain, lateral ankle sprain and acromioclavicular joint sprain. Survival models quantified within-player injury risk by comparing precommon (before) injury risk to postcommon (after) injury risk, whereas between-player subsequent injury risk was quantified by comparing players who had sustained one of the common injuries against those who had not sustained the common injury. HRs and 95% CIs were calculated. Specific body area and tissue type were also determined for new injuries.Results Concussion increased the within-player overall injury risk (HR 1.26 (95% CI 1.11 to 1.42)), elevating head/neck (HR 1.47 (95% CI 1.18 to 1.83)), pelvic region (HR 2.32 (95% CI 1.18 to 4.54)) and neurological (HR 1.38 (95% CI 1.08 to 1.76)) injury risk. Lateral ankle sprains decreased within-player injury risk (HR 0.77 (95% CI 0.62 to 0.97)), reducing head/neck (HR 0.60 (95% CI 0.39 to 0.91)), upper leg and knee (HR 0.56 (95% CI 0.39 to 0.81)), joint and ligament (HR 0.72 (95% CI 0.52 to 0.99)) and neurological (HR 0.55 (95% CI 0.34 to 0.91)) injury risk. Concussion (HR 1.24 (95% CI 1.10 to 1.40)), thigh haematomas (HR 1.18 (95% CI 1.04 to 1.34)) and hamstring muscle strains (HR 1.14 (95% CI 1.01 to 1.29)) increased between-player subsequent injury risk.Conclusion Elevated within-player injury risk was only evident following concussive injuries, while lateral ankle sprains reduced the risk. Both concussion and ankle injuries altered head/neck and neurological injury risk, but in opposing directions. Understanding why management of ankle sprains might be effective, while current concussion management is not at reducing such risks may help inform concussion return to play protocols.</abstract><type>Journal Article</type><journal>British Journal of Sports Medicine</journal><volume>57</volume><journalNumber>7</journalNumber><paginationStart>bjsports</paginationStart><paginationEnd>2021</paginationEnd><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0306-3674</issnPrint><issnElectronic>1473-0480</issnElectronic><keywords/><publishedDay>13</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-12-13</publishedDate><doi>10.1136/bjsports-2021-105238</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>Welsh Rugby Union. 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spelling v2 62187 2022-12-19 Concussion increases within-player injury risk in male professional rugby union 52effe759a718bd36eb12cdd10fe1a09 0000-0002-1667-7265 Jim Rafferty Jim Rafferty true false 2022-12-19 HDAT Objectives To assess within-player change in injury risk and between-player subsequent injury risk associated with concussive and common non-concussive injuries in professional rugby union.Methods This prospective cohort study in Welsh professional male rugby union analysed within-player and between-player injury risk for five common injuries: concussion, thigh haematoma, hamstring muscle strain, lateral ankle sprain and acromioclavicular joint sprain. Survival models quantified within-player injury risk by comparing precommon (before) injury risk to postcommon (after) injury risk, whereas between-player subsequent injury risk was quantified by comparing players who had sustained one of the common injuries against those who had not sustained the common injury. HRs and 95% CIs were calculated. Specific body area and tissue type were also determined for new injuries.Results Concussion increased the within-player overall injury risk (HR 1.26 (95% CI 1.11 to 1.42)), elevating head/neck (HR 1.47 (95% CI 1.18 to 1.83)), pelvic region (HR 2.32 (95% CI 1.18 to 4.54)) and neurological (HR 1.38 (95% CI 1.08 to 1.76)) injury risk. Lateral ankle sprains decreased within-player injury risk (HR 0.77 (95% CI 0.62 to 0.97)), reducing head/neck (HR 0.60 (95% CI 0.39 to 0.91)), upper leg and knee (HR 0.56 (95% CI 0.39 to 0.81)), joint and ligament (HR 0.72 (95% CI 0.52 to 0.99)) and neurological (HR 0.55 (95% CI 0.34 to 0.91)) injury risk. Concussion (HR 1.24 (95% CI 1.10 to 1.40)), thigh haematomas (HR 1.18 (95% CI 1.04 to 1.34)) and hamstring muscle strains (HR 1.14 (95% CI 1.01 to 1.29)) increased between-player subsequent injury risk.Conclusion Elevated within-player injury risk was only evident following concussive injuries, while lateral ankle sprains reduced the risk. Both concussion and ankle injuries altered head/neck and neurological injury risk, but in opposing directions. Understanding why management of ankle sprains might be effective, while current concussion management is not at reducing such risks may help inform concussion return to play protocols. Journal Article British Journal of Sports Medicine 57 7 bjsports 2021 BMJ 0306-3674 1473-0480 13 12 2022 2022-12-13 10.1136/bjsports-2021-105238 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University Welsh Rugby Union. The second author (CLB) was on a financially supported PhD, funded by the Knowledge Economy Skills Scholarships 2 (KESS2; grant number 82196). 2023-06-12T16:29:49.4645041 2022-12-19T17:05:43.4405274 Professional Services Isabel S Moore 0000-0002-4746-3390 1 Charlotte Leah Bitchell 0000-0002-0421-7392 2 Danielle Vicary 3 Jim Rafferty 0000-0002-1667-7265 4 Ben Charles Robson 5 Prabhat Mathema 6 62187__26262__156dcadca05943879615509f6fd00bc1.pdf 62187.pdf 2023-01-11T16:47:52.6832416 Output 484232 application/pdf Version of Record true © Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license true eng http://creativecommons.org/licenses/by-nc/4.0/
title Concussion increases within-player injury risk in male professional rugby union
spellingShingle Concussion increases within-player injury risk in male professional rugby union
Jim Rafferty
title_short Concussion increases within-player injury risk in male professional rugby union
title_full Concussion increases within-player injury risk in male professional rugby union
title_fullStr Concussion increases within-player injury risk in male professional rugby union
title_full_unstemmed Concussion increases within-player injury risk in male professional rugby union
title_sort Concussion increases within-player injury risk in male professional rugby union
author_id_str_mv 52effe759a718bd36eb12cdd10fe1a09
author_id_fullname_str_mv 52effe759a718bd36eb12cdd10fe1a09_***_Jim Rafferty
author Jim Rafferty
author2 Isabel S Moore
Charlotte Leah Bitchell
Danielle Vicary
Jim Rafferty
Ben Charles Robson
Prabhat Mathema
format Journal article
container_title British Journal of Sports Medicine
container_volume 57
container_issue 7
container_start_page bjsports
publishDate 2022
institution Swansea University
issn 0306-3674
1473-0480
doi_str_mv 10.1136/bjsports-2021-105238
publisher BMJ
college_str Professional Services
hierarchytype
hierarchy_top_id professionalservices
hierarchy_top_title Professional Services
hierarchy_parent_id professionalservices
hierarchy_parent_title Professional Services
document_store_str 1
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description Objectives To assess within-player change in injury risk and between-player subsequent injury risk associated with concussive and common non-concussive injuries in professional rugby union.Methods This prospective cohort study in Welsh professional male rugby union analysed within-player and between-player injury risk for five common injuries: concussion, thigh haematoma, hamstring muscle strain, lateral ankle sprain and acromioclavicular joint sprain. Survival models quantified within-player injury risk by comparing precommon (before) injury risk to postcommon (after) injury risk, whereas between-player subsequent injury risk was quantified by comparing players who had sustained one of the common injuries against those who had not sustained the common injury. HRs and 95% CIs were calculated. Specific body area and tissue type were also determined for new injuries.Results Concussion increased the within-player overall injury risk (HR 1.26 (95% CI 1.11 to 1.42)), elevating head/neck (HR 1.47 (95% CI 1.18 to 1.83)), pelvic region (HR 2.32 (95% CI 1.18 to 4.54)) and neurological (HR 1.38 (95% CI 1.08 to 1.76)) injury risk. Lateral ankle sprains decreased within-player injury risk (HR 0.77 (95% CI 0.62 to 0.97)), reducing head/neck (HR 0.60 (95% CI 0.39 to 0.91)), upper leg and knee (HR 0.56 (95% CI 0.39 to 0.81)), joint and ligament (HR 0.72 (95% CI 0.52 to 0.99)) and neurological (HR 0.55 (95% CI 0.34 to 0.91)) injury risk. Concussion (HR 1.24 (95% CI 1.10 to 1.40)), thigh haematomas (HR 1.18 (95% CI 1.04 to 1.34)) and hamstring muscle strains (HR 1.14 (95% CI 1.01 to 1.29)) increased between-player subsequent injury risk.Conclusion Elevated within-player injury risk was only evident following concussive injuries, while lateral ankle sprains reduced the risk. Both concussion and ankle injuries altered head/neck and neurological injury risk, but in opposing directions. Understanding why management of ankle sprains might be effective, while current concussion management is not at reducing such risks may help inform concussion return to play protocols.
published_date 2022-12-13T16:29:47Z
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score 11.016258

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