Aims and objectives: To investigate the epidemiology, risk factors, and preventive strategies for serious head and spinal injuries related to rugby league and union football in New South Wales (NSW). Methods: The three main components of this study included. 1. A retrospective analysis of clinical and compensation case file records during the 16-year period, 1984-1999. 2. A review of game rules, weights and heights of players, over the past 100 years. 3. A review of film and video footage of rugby football games spanning most of the 20th century. A method was developed to allow valid comparisons in style of play over a 70-year period. Results: The estimated annual incidence rate of SCI for rugby league players was 1.9 (95%CI 1.3 - 2.8) per 100,000 estimated players per year, and 3.3 (95%CI 2.2 - 4.8) per 100,000 estimated rugby union players per year over the study period 1984 to 1999. There was no significant change in the incidence of rugby league related serious spinal cord injuries (1984-1999), fatalities (1984-1999) or serious head injuries (1984-1999). There was a small but significant decline in rugby union related serious spinal cord injuries (1984-1999, P<0.05). However, the relative risk of spinal cord injury was 1.34 times greater for rugby union compared to rugby league over the entire study period (95%CI 1.01 - 1.67, P<0.05). For rugby football, the evidence suggested that the force of impact between participants was a key causal risk factor for serious injury. Elite rugby league and union players from 1999-2000 teams were significantly heavier (P<0.05) and taller (P<0.05) than players pre 1950. Players in modern elite games post 1989 were more likely to be tackled by multiple opponents (P = 0.000), tackled head on (P<0.05), at chest level (P<0.05) and at greater speeds than their earlier counterparts pre 1958. However, modern players appear to be no more aggressive or perpetrate greater foul play than their predecessors. Conclusions: There was a continued annual occurrence of catastrophically serious injuries leading to permanent brain damage and quadriplegia associated with rugby league and union in NSW. The critical risk factors found to be associated with serious injury in rugby football suggest relatively novel approaches to the development of preventive strategies.

No abstract available. / Thesis (M.Physio.)-University of KwaZulu-Natal, Westville, 2012.

Aims and objectives: To investigate the epidemiology, risk factors, and preventive strategies for serious head and spinal injuries related to rugby league and union football in New South Wales (NSW). Methods: The three main components of this study included. 1. A retrospective analysis of clinical and compensation case file records during the 16-year period, 1984-1999. 2. A review of game rules, weights and heights of players, over the past 100 years. 3. A review of film and video footage of rugby football games spanning most of the 20th century. A method was developed to allow valid comparisons in style of play over a 70-year period. Results: The estimated annual incidence rate of SCI for rugby league players was 1.9 (95%CI 1.3 - 2.8) per 100,000 estimated players per year, and 3.3 (95%CI 2.2 - 4.8) per 100,000 estimated rugby union players per year over the study period 1984 to 1999. There was no significant change in the incidence of rugby league related serious spinal cord injuries (1984-1999), fatalities (1984-1999) or serious head injuries (1984-1999). There was a small but significant decline in rugby union related serious spinal cord injuries (1984-1999, P<0.05). However, the relative risk of spinal cord injury was 1.34 times greater for rugby union compared to rugby league over the entire study period (95%CI 1.01 - 1.67, P<0.05). For rugby football, the evidence suggested that the force of impact between participants was a key causal risk factor for serious injury. Elite rugby league and union players from 1999-2000 teams were significantly heavier (P<0.05) and taller (P<0.05) than players pre 1950. Players in modern elite games post 1989 were more likely to be tackled by multiple opponents (P = 0.000), tackled head on (P<0.05), at chest level (P<0.05) and at greater speeds than their earlier counterparts pre 1958. However, modern players appear to be no more aggressive or perpetrate greater foul play than their predecessors. Conclusions: There was a continued annual occurrence of catastrophically serious injuries leading to permanent brain damage and quadriplegia associated with rugby league and union in NSW. The critical risk factors found to be associated with serious injury in rugby football suggest relatively novel approaches to the development of preventive strategies.

Dissertation (Ed.D.)--The University of North Carolina at Greensboro, 2010. / Directed by Jolene Henning; submitted to the Dept. of Kinesiology. Title from PDF t.p. (viewed Jul. 9, 2010). Includes bibliographical references (p. 70-76).

Thesis (M.A.)--University of Port Elizabeth, 2003. / Includes bibliographical references (leaves 217-243).

Background: Clothing and protective gear worn during intermittent exercise has shown to increase physiological and perceptual responses, and negatively impact performance capacities, due to increased heat strain, suggested to hasten the onset of fatigue. However, the mechanisms of fatigue experienced in rugby remain unclear. Objectives: The aim of this study was establish whether clothing and protective gear worn during a simulated rugby protocol impacts players‘ biophysical, physiological, perceptual and performance responses. Methods: 15 registered university and school first XV rugby players with a mean (± SD) age of 20.9 years (± 1.9) volunteered to participate in the study. Testing was performed in a controlled laboratory setting, with temperatures having to be within the range of 16º C-22º C. The mean (± SD) ambient temperature was 17.6º C (± 1.6) for the control condition and 17.3º C (1.5) for the experimental condition. The mean (± SD) relative humidity was 65.2 % (± 9.5) for the control condition and 66.3 % (± 10.0) for the experimental condition. Player‘s performed two protocols of 80-minutes; a control condition (minimal clothing and protective gear) and an experimental condition (full clothing and protective gear). Physiological, perceptual and performance responses were measured at set intervals during the protocol, while biophysical responses were measured pre-, at half-time and post-protocol during a 3-minute EMG treadmill protocol. Results: Muscle activity significantly (p< 0.05) increased with increasing running speeds. There were no significant (p> 0.05) differences for muscle activity between conditions, except for the semitendinosus muscle, which was significantly (p< 0.05) higher during the control condition while running at high speeds. Players‘ heart rates, core temperatures and perceptual responses were significantly (p< 0.05) higher during the experimental condition, compared to the control condition. Performance responses were significantly (p< 0.05) lower during the experimental condition. Conclusion: The main driver of physiological and perceptual responses was the exercise itself. However, the additional clothing and protective gear exacerbated the responses, particularly towards the end stages of the protocol. This negatively impacted players‘ performance. Muscle activity appeared to be unaffected by increased body temperatures. However, core temperatures never reached critically high levels during either condition.

The present study is part of a larger and ongoing research initiative investigating the cumulative cognitive effects of mild head injury in rugby union and focused specifically on high school rugby players. A comprehensive battery of neuropsychological tests was administered to top team high school rugby players (n = 47), and a non-contact sport control group of top team high school hockey players (n = 34). Direct comparisons of group mean scores and standard deviations across each neuropsychological test were carried out for the Total Rugby group versus the Total Hockey group as well as for the subgroups Rugby Forwards versus Rugby Backs. A correlational analysis was conducted to ascertain whether a relationship exists between the number of mild head injuries reported by the players and their cognitive test performance. Results of the group comparisons of means and variability on WMS Paired Associate Learning Hard Pairs - Delayed Recall provides tentative indications of the initial stages of diffuse damage associated with mild head injury in the rugby group and provides some evidence for impairment of verbal learning and memory in the Rugby Forwards group. The correlational analysis revealed no significant relationship between number of reported mild head injuries and cognitive performance. The findings and possible latent effects of the multiple mild head injuries reported by the rugby players are discussed in terms of brain reserve capacity theory and suggestions for future research are provided.

This study investigates the effects of cumulative concussive and subconcussive mild head injury on the cognitive functioning of professional rugby players. A comprehensive battery of neuropsychological tests was administered to 26 professional rugby players and a noncontact sport control group of 21 professional cricket players. The test performances of the rugby players were compared to those of the cricket players. Within the rugby group, forward and backline players were compared. An analysis of mean score differences between the rugby and cricket group failed to support the presence of brain damage effects in the rugby group. However, there was significantly increased variability of scores for the rugby players compared with the cricket players on tests particularly sensitive to cognitive deficit associated with mild head injury. This invalidates the null indications of average effects, indicating that a notable proportion of rugby players’ performances were falling off relative to the rest of the rugby players on tests vulnerable to the cognitive effects of diffuse brain damage. Mean score comparisons within the rugby group indicated that it was the subgroup of forward players, in particular, whose test performances revealed deficits suggestive of cerebral damage. Specifically, deficits were found in working memory, visuoperceptual tracking, verbal memory and visual memory, a pattern of deficits commensurate with cumulative mild head injury. The theoretical perspectives of Satz’s (1997) Brain Reserve Capacity Theory and Jordan’s (1997) ‘Shuttle’ model of variability are drawn upon in order to elucidate research findings and suggestions for future research are provided.

sustained multiple concussions may be at risk of cumulative impairment. The role of neuropsychological testing in the management of sports-related concussion is a contentious and challenging issue which has gained credibility given the lack of clear and well-established guidelines pertaining to the diagnosis, assessment and return-to-play decisions following concussion. Despite various traditional paper and pencil tests being shown to be effective indicators of postconcussive neuropsychological dysfunction, testing has not been widely implemented, due to time- and labour-demands. ImPACT, a computer-based neuropsychological assessment instrument, has been recognised as a valid and reliable tool in the monitoring of athletes' symptoms and neurocognitive functioning preseason and postconcussion. As a part of larger-scale concussion research conducted on top-team university rugby players, this is an in-depth case study conducted on a 20-year old participant with a history of multiple concussions, who was referred following a concussion sustained during the season. The objectives of the study were: (i) to determine the sensitivity of ImPACT versus WAIS-III Digit Span and Trail Making Test during the acute postconcussive phase; and (ii) to examine the sensitivity of ImPACT versus a comprehensive battery of neuropsychological tests to possible residual deficits as a result of the multiple concussions. ImPACT was determined to be more sensitive to acute postconcussive impairment following concussion than Digit Span and Trail Making Test. Furthermore, the ImPACT preseason baseline scores appear to be sensitive to neurocognitive dysfunction, possibly due to cumulative concussive injuries.

This study investigates the cumulative effects of concussive and subconcussive mild head injury on the cognitive functioning of schoolboy rugby players. A comprehensive battery of neuropsychological tests and a self-report postconcussive questionnaire were administered to top level schoolboy rugby players (n=47), and a non-contact sport control group of top level schoolboy hockey players (n=34). Group comparisons of the percentage of individuals with cognitive deficit were carried out between i) the schoolboy rugby and the schoolboy hockey players, ii) the rugby forward and the rugby backline players; iii) the rugby forward and the schoolboy hockey players and, iv) the rugby backline and the schoolboy hockey players. Results on the neuropsychological test battery did not provide any substantial evidence of a higher level of neuropsychological impairment in the rugby players relative to the control group, or in the rugby forward players relative to the rugby backline players. Results obtained on the postconcussive symptom questionnaire provided tentative indications that the rugby players do report a greater frequency of postconcussive symptomatology. The symptoms most frequently reported were being easily angered, memory problems, clumsy speech and sleep difficulties. It was hypothesized that the absence of cognitive impairment in the schoolboy rugby players compared with that noted for professional players was due to their younger age, relatively high IQ and education level and a less intensive level of physical participation in the sport, and hence less accumulated exposure to the game, thereby decreasing their exposure to mild head injuries. From a theoretical perspective, these pre-existing conditions were considered to act as protective factors against reductions in brain reserve capacity and concomitant susceptibility to the onset of neuropsychological dysfunction.