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  1. Christopher Bosshardt1,
  2. Courtney Kipps1,
  3. Mike England2
  1. 1Institute of Sport, Exercise and Health, 170 Tottenham Court Road, London W1T 7HA,, ISEH, University College London, London, United Kingdom
  2. 2Director RFU Injured Players Foundation and Medical Director RFU Rugby Development, RFU,, London, United Kingdom


    Background Concussion is a common injury in school-boy rugby, if managed incorrectly it can have serious consequences such as further injury, prolonged symptoms, and second impact syndrome. Adolescent players show poor knowledge levels and symptoms-reporting behaviour.

    Objective Investigate the effects of an educational presentation on the knowledge and behaviour of school age rugby players regarding concussion.

    Design Questionnaire based study.

    Setting 120 male rugby players, aged 16–18.

    Participants Three large rugby union playing schools in England.

    Interventions Independent Variable – Educational presentation aimed at school-age rugby players to improve their education and behaviours related to the condition. Players completed a questionnaire testing for likely behavioural responses from a selection of common concussion scenarios. Additional questions assessed knowledge of concussion symptoms, diagnosis and management. The questionnaires were completed pre-season and repeated 2–3 months after the presentation.

    Outcome Dependent variable: Questionnaire scores.

    Results The students had significantly improved their responses giving 53.9% appropriate responses after the presentation (Md=55, n=34) compared to 46.1% before (Md=33.5, n=34) (U=400, Z=−2.18, p=0.029) with a moderate effect size (r=0.37). The knowledge of students increased from 37.85% correct responses before (Md=28, n=35) and 44.07% on follow up (Md=28, n=35) but with no significant difference (U=575.5, Z=−0.88, p=0.378 with a small effect size (r=0.15)). Completed surveys showed increased awareness of guidelines from 19.4% to 73.2% (p=0.00 McNemar's Test).

    Conclusions The students had showed improved concussion behaviour in response to concussion scenarios at 2–3 month follow up in contrast to previous studies on educational interventions. There was no increase in players' knowledge of concussion. The literature shows increases in short-term knowledge with other forms of concussion education but this effect is often lost at long term follow up. There was increased awareness of guidelines. Future concussion education should be modelled on the educational presentation to improve behavioural outcomes.

    • Injury

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