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  1. Michael Hislop1,
  2. Keith Stokes1,
  3. Sean Williams1,
  4. Carly McKay1,
  5. Simon Kemp2,
  6. Mike England2,
  7. Grant Trewartha1
  1. 1Department for Health, University of Bath, Claverton Down, Bath, United Kingdom
  2. 2Rugby Football Union, Twickenham, London, United Kingdom


    Background Structured pre-activity exercise programmes have demonstrated injury prevention in a variety of settings, but their efficacy is largely unknown in contact-orientated sports.

    Objective To 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.

    Design Single-blind cluster-randomised controlled trial.

    Setting Independent schools within England during the 2015/16 playing season.

    Participants Schools 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.

    Interventions Both 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 Measures Trial-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).

    Results 441 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).

    Conclusions This 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.

    • Injury

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