Abstract
BackgroundStructured pre-activity exercise programmes have demonstrated injury prevention in a variety of settings, but their efficacy is largely unknown in contact-orientated sports.ObjectiveTo assess the efficacy of a pre-activity movement control exercise programme to reduce injury risk in youth rugby when compared with a standardised exercise programme.DesignSingle-blind cluster-randomised controlled trial.SettingIndependent schools within England during the 2015/16 playing season.ParticipantsSchools with onsite medical provision were eligible to participate in this trial. 31 schools (intervention, 17 schools, 1,325 players; control, 14 schools, 1,127 players) completed the trial.InterventionsBoth programmes were completed for 15–20 minutes prior to main sessions, with team coaches acting as delivery agents. The intervention programme combined progressive proprioceptive, resistance, and plyometric activities. The standardised programme combined dynamic stretching, wrestling-based and speed-based activities.Main Outcome MeasuresTrial-arm comparisons were made across summary measures of time-loss (>24 hours) injuries, with effects analysed through magnitude-based inference against thresholds for the smallest worthwhile effects (RR=0.90 & 1.11).Results441 time-loss injuries (intervention, 233; control, 208) were reported across 15,953 match exposure-hours (intervention, 9,083 hours; control, 6,870 hours). Intention-to-treat analyses revealed a 15% reduction in overall match injury incidence favouring the intervention (relative risk=0.85, 90% CI 0.61–1.17, unclear effect), whilst reductions were also identified in match concussion incidence (RR=0.71, 0.48–1.05, likely beneficial effect). Per-protocol analyses revealed that completing the intervention programme compared with the control programme an average of 2x/week was associated with a further reduction in overall match injury incidence (RR=0.73, 0.45–1.20, unclear effect), whilst an average use of 3x/week halved overall match injury incidence (RR=0.50, 0.22–1.13, likely beneficial effect).ConclusionsThis study presents encouraging evidence that using a preventive exercise programme 2–3x/week prior to training and matches can reduce injury risk in youth rugby when compared with a standardised programme.
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