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Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Union Youth Week Tournaments

Mc Fie, Sarah BSc; Brown, James PhD; Hendricks, Sharief PhD; Posthumus, Michael PhD; Readhead, Clint BSc; Lambert, Mike PhD; September, Alison V. PhD; Viljoen, Wayne PhD

Clinical Journal of Sport Medicine: September 2016 - Volume 26 - Issue 5 - p 398–404
doi: 10.1097/JSM.0000000000000276
Original Research

Objective: To determine the concussion incidence and to identify factors associated with concussion in South African youth rugby union players.

Design: Prospective cohort study.

Setting: Injury surveillance was completed at the South African Rugby Union Youth Week tournaments (under-13, under-16, and under-18 age groups).

Participants: South African youth rugby union players. A total of 7216 players participated in 531 matches between 2011 and 2014.

Interventions: None.

Main Outcome Measures: Concussion incidence was calculated per 1000 player-match-hours with 95% CIs. Poisson regression was used to calculate the incidence rate ratio (IRR) between factors (age, time period, playing position, and activity at the time of concussion) potentially associated with concussions.

Results: The concussion incidence was 6.8/1000 player-match-hours (95% CI, 5.5-8.1) across all age groups. Under-13s (IRR, 1.5; P = 0.09) and under-16s (IRR, 1.7; P = 0.03) had higher concussion incidence rates than the under-18 age group. The incidence was higher in the third (IRR, 2.1; P = 0.04) and fourth (IRR, 2.5; P = 0.01) quarters of matches compared with the first quarter. Sixty-two percent of concussions occurred in the tackle situation. The tackler had a 4-fold greater concussion rate (IRR, 4.3; P < 0.001) compared with the ball carrier. The hooker and loose forwards had higher incidence rates than several other player positions (P < 0.05).

Conclusions: The reported concussion incidence falls within the broad range previously reported in youth rugby. The evidence highlighted in this study may contribute to targeted concussion prevention strategies and provide a baseline against which the effectiveness of future interventions can be measured.

*Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and

Medical Department, South African Rugby Football Union, Cape Town, South Africa.

Corresponding Author: Wayne Viljoen, PhD, SARU House, 163 Uys Krige Drive, Tygerberg Park, Plattekloof, 7500 Cape Town, South Africa (waynev@sarugby.co.za).

S.M. was funded by the South African National Research Foundation and the University of Cape Town. M.P. was funded by the Thembakazi Trust. W.V. and C.R. are full-time employees of SARU.

The authors report no conflicts of interest.

Received February 23, 2015

Accepted September 08, 2015

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