 on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Better understanding of concussion injury mechanisms in youth rugby union.
Injury prevention programmes may offer targeted training interventions to prevent concussion in youth rugby.
A video analysis method to describe and compare injury mechanisms of concussion to a representative non-injury sample.
A concussion is defined as “a complex pathophysiological process affecting the brain, induced by biomechanical forces”.1 On the basis of a meta-analysis of 29 papers, Gardner et al2 reported an overall incidence of match play concussion in men's rugby union of 4.7 concussions per 1000 player match hours (range 0.2–17.1). Considering the level of play, elite players have a rate of 0.40 concussions per 1000 player match hours (0.3–7.8), schoolboys 0.6 per 1000 player match hours (0.2–10.6), and community-level or subelite-level players 2.1 concussions per 1000 player match hours (1.2–6.9).2
Epidemiological studies serve to identify the extent of the problem and, in doing so, satisfy the first step in van Mechelen's ‘sequence of prevention’ model and the Translating Research into Injury Prevention Practice (TRIPP) model.3 ,4 In both injury prevention models, the second step is to establish the aetiology and the mechanisms of injury. A weakness of many sports injury studies is that the injury mechanisms have been insufficiently described to identify suitable injury prevention strategies.5 Furthermore, a multifactorial approach is required to account for all the factors involved, that is, the inciting event and also the global and local injury mechanisms.5 ,6
A systematic video analysis of injuries provides valuable information on the playing situation and athlete movement patterns, which can be used to formulate injury prevention strategies.7 Video analysis has been utilised in rugby union to study injury mechanisms in tackle contact situations8–10 and specifically for concussion in sports such as American football11 and ice hockey.12–14 In the Canadian NHL, for example, 3½ years of video records and all cases of medically diagnosed concussions were analysed using a standardised framework for coding the mechanisms of concussions.12–14 When studying injury using video analysis, the majority of studies are limited to studying the injury event only. The more favourable approach would be to understand the athlete's injury event in comparison with a representative ‘control’ sample of non-injury events. Using this approach, one would be able to identify differences or deficiencies in the injury event compared with the non-injury event. Moreover, in a technically demanding sport such as rugby, where technical proficiency is a risk factor for injury,15 ,16 this approach will allow for the study of technical discrepancies between the injury and representative non-injury sample.
The implementation of an effective injury prevention strategy relies on a clarification of the extent of the injury problem, and the identification of the injury mechanism. Given the breadth of epidemiological studies on concussion in rugby, the studies identifying the mechanism of injury are lacking. Therefore, we conducted a video analysis of the mechanism of concussion injury in junior level rugby union and compared it with a representative and matched non-injury sample.
Injury surveillance was completed as previously described between 2011 and 2013 at the annual South African Rugby Union (SARU) Coca-Cola Youth Week tournaments.17 Focusing on the under-18 Craven Week tournaments only, data were obtained from the SARU injury database that is part of an ongoing injury surveillance project coordinated in conjunction with the BokSmart National Rugby Safety Programme.18 Video footage containing the concussion injury events at the under-18 Craven Week tournament was also accessed for analysis from the SARU video database. Over the 3 years, 18 concussions were recorded. However, only 10 were