Abstract
Understanding and preventing concussion in youth contact sport is important. The incidence of concussion in South African youth rugby is largely unknown. PURPOSE: The aim of this study was to determine the incidence of concussion in South African youth rugby players. METHODS: Injury surveillance was completed at the South African Rugby Union (SARU) Youth Week tournaments at three different age-grades (under-13, under-16 and under-18) between 2011 and 2014. All concussion/suspected concussion injuries were diagnosed by SARU appointed Tournament Doctors using standard clinical criteria. The concussion/suspected concussion injuries were combined for the analysis. The resulting combined concussion incidence was calculated per 1000 player-match-hours with a 95% confidence interval (95% CI). Poisson regression analysis was used to identify possible factors associated with concussion. RESULTS: In total, 108 concussions were documented at an incidence of 6.8/1000 player-match-hours (95% CI 5.5 - 8.1). Concussion accounted for 12.3% of all injuries and 30.8% of all time-loss injuries. A concussion occurred on average once every 4.9 games. The under-16 age group had a higher concussion rate than the under-18 age group (IRR: 1.7, 95% CI 1.1 - 2.6, p=0.025). The concussion rate progressively increased in the four quarters of the game with a higher rate in the fourth compared to the first quarter (IRR: 2.5, 95% CI 1.2 - 4.1, p=0.011). The majority of concussions were tackle-related (57%), with a four-fold higher risk of concussion while executing a tackle, as opposed to being tackled (IRR: 4.3, 95% CI 2.0 - 9.2, p<0.001). The hooker had a higher incidence than other player positions (p<0.05), while the scrumhalf displayed a lower incidence than other player positions (p<0.05). CONCLUSIONS: The concussion incidence is within the broad range of youth rugby concussion data previously reported, but is higher than several rates reported in the adult game. The under-16 age group had a greater risk for concussion and the reasons behind this require further exploration. The act of executing a tackle was the mechanism most associated with concussion. Coaches must place a greater emphasis on coaching correct, safe and effective tackling techniques, where the head is less exposed to impact and concussion risk.
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