Browsing by Author "Brown, James"

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    Open Access
    Injury incidence and severity at the South African Rugby Union (SARU) Youth Weeks Tournaments: a four year study
    (2018) Marsh, Jarred; Lambert, Michael I; Brown, James
    Introduction Rugby Union (hereinafter referred to as ‘rugby’) is a contact sport with players being exposed to repetitive collisions throughout a match. As the risk of injury is relatively high, incidence surveillance studies within rugby has become popular. However most of the studies have focussed on senior players. The data on injuries among youth rugby players are limited. This makes it difficult to develop the game to make it safer for youth of all ages. Objectives The first objective of this study was to establish if any injury trends exist across different ages of youth rugby players (13 to 18 years). The second objective was to determine the patterns of injuries changed over four years (2011 to 2014). Methods The South African Rugby Union (SA Rugby) hosts four local youth tournaments annually to for local rugby talent: Craven Week under-13, Grant Khomo under-16, Academy Week under-18 and Craven Week under-18. Injury data were collected from the four SARU Youth Week Tournaments between 2011 and 2014. These data were compiled into one central SARU injury surveillance database. Injury categories were used to group data: ‘Type’, ‘Location’, ‘Event’ and ‘Severity’ of injury were assessed. Injuries were defined as either ‘Time-loss’ (those injuries that prevented a player from match participation for one or more days), or ‘Medical attention’ (injuries that required the player to seek medical attention at the time of or after injury but were not required to miss a match). Injury rates were represented by injury incidence densities (IIDs) (corresponding 95% confidence intervals (95% CIs) for IID were calculated for the number of injuries regardless of whether one person was injured more than once) per 1000 hours of match play. Incidence densities were considered to be significantly different from each other if their 95% CIs did not overlap and using Poisson regression analysis. Results The ‘overall’ combined IID across all four years was 54.6 injuries per 1000 hours of match play (95%CI: 51.0-58.2). The combined ‘time-loss’ IID was 18.9 injuries per 1000 hours of match play (95%CI: 16.8-21.0). ‘Time-loss’ injuries were greatest in 2011 (23.2 per 1000 match hours (95% CI: 18.5-28.0)). However, ‘time-loss’ injuries rates were significantly reduced in 2013, when compared to these injury rates in 2011 (13.3 (9.7-17.0). Craven Week under-13 presented significantly greater ‘overall’ injury incidence densities when compared to the older age groups (71.9 per 1000 match hours (95% CI: 62.4-81.4)). Overall, joint/ligament/tendon injuries were most common ‘overall’ and ‘time-loss’ injury sustained by players between 2011 and 2014 (30% and 33% respectively). This was followed closely by concussion injuries, which accounted for 29% of ‘time-loss’ and 12% of ‘overall’ injuries. A large proportion of both ‘overall’ (57%) and ‘time-loss’ (55%) injuries occurred during the tackle event, with the tackler being injured more often than the ball-carrier (37% and 18% respectively). However, there were no statistically significant differences when comparing ‘overall’ and ‘time-loss’ IID between the different tournaments from 2011 until 2014. Discussion Significant differences were found when comparing ‘overall’ and ‘time-loss’ IID between the different tournaments from 2011 until 2014. Craven Week under-13 presented significantly greater ‘overall’ injury incidence densities. This finding contradicts previous literature within youth rugby research. The tackle (combination of tackler and ball-carrier) still accounts for the highest proportion both ‘time-loss’ and ‘overall’ injury events (57% and 55% respectively). This is in accordance with previous studies. However, a point of concern was that concussion accounted for 29% of all ‘time-loss’ injuries and 12% of all ‘overall’ injuries. This finding suggests a gradual increase in the number of concussions suffered during the SARU Youth Week Tournaments between 2011 and 2014. Further research is required to determine the reason for this pattern. Conclusion Further research within youth rugby cohorts is required to determine the risk associated with involvement at various level of participation. Injury prevention programs should place focus on reducing the prevalence of concussion at youth level by educating players and coaches about safe tackle techniques. Future studies should focus on local youth cohorts for seasonal
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    Life after the game: consequences of acute spinal cord injuries in South African rugby union players
    (2019) Badenhorst, Marelise; Lambert, Mike; van Mechelen, Willem; Verhagen, Evert; Brown, James
    There is a well described association between participation in exercise and sport and the positive effects of physical, social and psychological health. 1,2 Rugby union is a popular team sport across many countries.3 As a team sport, rugby shares these positive benefits. However, the physical demands of the game means that it is also associated with a risk of serious injuries, such as spinal cord injuries (SCIs). 4–6 SCIs have profound long-term effects on every aspect of a person’s life, including their overall quality of life (QoL).7–10 As such, a nationwide injury prevention programme called ‘BokSmart’ was launched in South Africa in 2009, with the aim to reduce and ultimately prevent these injuries.11,12 However, implementing an injury prevention programme in a country with vast socio-economic disparities, such as South Africa, is a difficult task.13 Additionally, optimal acute care after the injury, rehabilitation services and ongoing health maintenance are essential in the management of SCIs and may play a determining role in enhancing and maintaining health and functioning, and therefore QoL.14–16 In South Africa, socio-economic disparities also have a profound effect on healthcare access and the subsequent health of the population. 14 Thus, the additional burden of an injury with permanent consequences may be substantial and is an important issue to investigate. This introductory chapter summarises the literature on the incidence and risk factors for rugby-related SCIs, and the immediate management of these injuries. It also summarises the long-term healthcare issues and overall QoL of players who sustain these injuries and identifies how these problems present both globally and in South Africa. This chapter also provides the overall structure of this PhD-thesis.
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    The effectiveness and implementation of the BokSmart Safe Six Injury prevention programme
    (2018) Sewry, Nicola Ann; Van Mechelen, Willem; Lambert, Mike; Verhagen, Evert; Brown, James
    INTRODUCTION: Injury prevention programmes in rugby union are important to reduce the sport’s injury burden. The BokSmart Safe Six exercise-based injury prevention programme (“Safe Six”) was designed for this purpose. The programme incorporates six targeted exercises as a warm-up for rugby players. The effectiveness of the BokSmart Safe Six programme was assessed using the “Sequence of Prevention” Model. METHODS: The first study was a prospective cohort study using injury surveillance, of players at the South African Rugby (SA Rugby) Youth week tournaments. The study was conducted over six years to determine the injury incidence density (IID) youth players and also factors associated with the IID. The second study was a systematic review with the purpose of determining the effectiveness of exercise-based injury prevention interventions to reduce injury rates in collision sports. The next study was conducted over three years of SA Rugby Youth weeks and assessed the awareness of coaches and players of the BokSmart Safe Six following a targeted-marketing approach. This was followed by a study in which the BokSmart Safe Six programme was implemented in a cohort of apparently healthy non-rugby playing adults. The aim of this study was to determine the efficacy of the programme on injury risk profiles (Functional Movement Screening and Musculoskeletal Screening Assessments). The final study was a cluster-randomised controlled trial (cRCT) over eight weeks, using six schools (n = 210 players) in the Western Cape to determine the effectiveness of the BokSmart Safe Six on injury risk profiles and IID. RESULTS AND CONCLUSIONS: SA youth rugby cohort have a similar IID to other youth rugby cohorts (and in some instances lower). The systematic review identified only one highlevel study (out of three) that was effective for injury prevention. The players’ awareness of the BokSmart Safe Six was associated with the awareness of their specific coaches’ awareness. The awareness increased during the targeted marketing approach. The BokSmart Safe Six was associated with minimal significant improvements of the injury risk profiles in both the healthy adults and in the cRCT intervention group youth rugby players.