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  1. Victor Lopez1,2,3,4,
  2. Richard Ma1,5,
  3. Meryle Weinstein1,6,
  4. Patria Hume2,
  5. Robert Cantu7,8,9,10,11,
  6. Laurel Myers1,4,
  7. Christian Victoria1,12,
  8. Nisha Nadkar1,13,
  9. Allen Answorth1,4,14,15,16
  1. 1Rugby Research and Injury Prevention Group, Hospital for Special Surgery, New York, NY, USA
  2. 2Auckland University of Technology, Sports Performance Research Institute New Zealand, Rugby Codes Interdisciplinary Research Group, Auckland, New Zealand
  3. 3USA Rugby Empire Geographic Union Rugby Football Union, New York, NY, USA
  4. 4Northeast Rugby Academy, USOC-Community Olympic Development Program, New York, NY, USA
  5. 5University of Missouri, Missouri Orthopaedic Institute & Comparative Orthopaedic Laboratory, Columbia, MO, USA
  6. 6New York University, Steinhardt School of Culture, Education and Human Development, New York, NY, USA
  7. 7Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA, USA
  8. 8Department of Neurosurgery and Sports Medicine, Emerson Hospital, Concord, MA, USA
  9. 9Neurologic Sports Injury Center, Brigham and Women's Hospital, Boston, MA, USA
  10. 10Sports Legacy Institute, Waltham, MA, USA
  11. 11World Rugby, Independent Concussion Group, Dublin, Ireland
  12. 12New York University, Global Institute of Public Health, New York, NY, USA
  13. 13Kessler Institute for Rehabilitation, West Orange, NJ, USA
  14. 14Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
  15. 15National Basketball Association, New York Knickerbockers, New York, NY, USA
  16. 16USA Basketball, Colorado Springs, CO, USA


    Background Rugby-7s an emerging sport in the United States (US) encounters concussions, a growing public concern.

    Objective To report incidence of concussions in US Rugby-7s. We hypothesized that concussive injuries would occur with frequency in US Rugby-7s similar to international cohorts.

    Design Prospective descriptive epidemiology study.

    Setting The study encompassed U19 to elite players in USA Rugby tournaments (2010–2013).

    Participants A total of 13,644 US players (Men=9,768; Women=3,876; age: 13–49 years) were included over 28 tournaments of 2,688 matches (Men=1,886; Women=802) in 1,137 sides/teams (Men=814; Women=323).

    Assessment of Risk Factors Intrinsic and extrinsic risk factors in match injuries.

    Main measurement outcome Incidence (per 1000 player-hour (ph)) and mechanism, captured using Rugby Injury Survey & Evaluation (RISE) Report methodology. Time-loss injuries=defined as players who did not return to play the day of their injury. Severity=defined as days absent before return to training/competition (including post tournament).

    Results Incidence of concussive injuries was 7.7/1000 ph. No difference was noted between women (8.1/1000 ph, n=21) or men (7.6/1000 ph, n=46; P=0.593). Most concussions had “no loss of consciousness” (86.6%; n=58). Higher levels of competition encountered greater incidence (18.3/1000 ph vs. 6.4/1000 ph; P=0.001). Concussions resulted in a mean 30.6 days absent from competition (range=0–135 days) for the 97% of players with follow-up data. Compliance with the 3-wk stand-down return-to-play recommendations was found at 60%. Players reported a repeat concussion at 43.2% (12 months). Players who had multiple concussions within a year, encountered more severity (42.8 mean days absent; CI=23.0–62.6; P=0.03).

    Conclusions The 7.7/1000 ph incidence of concussion among US amateur Rugby-7s is concerning given international incidences range from 2.0 to 8.3/1000 ph. The 40% of players non-compliant with the recommended 3-week stand-down regulation indicates that a formal mechanism to “clear” players for return to play is needed for Rugby-7s.

    • Injury

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