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Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial
  1. Matthew J Attwood1,2,
  2. Simon P Roberts1,
  3. Grant Trewartha1,
  4. Mike E England3,
  5. Keith A Stokes1
  1. 1 Department for Health, University of Bath, Bath, UK
  2. 2 School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
  3. 3 Rugby Football Union, Twickenham, London, UK
  1. Correspondence to Dr Keith A Stokes, Department for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK; k.stokes{at}


Background Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking.

Objective To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players.

Methods 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.

Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries.

Results Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).

Conclusions The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.

  • injury prevention
  • lower limb
  • concussion
  • neuromuscular

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  • Contributors KAS, GT, SPR and MEE initiated the overall project. MJA, KAS, GT, SPR and MEE conceived and designed the study. MJA, KAS, GT and SPR collected and analysed data. MJA prepared the first draft of the manuscript. All authors made substantial contributions to revision of the document prior to submission.

  • Funding This research is funded by the Rugby Football Union and the Private Physiotherapy Education Fund.

  • Ethics approval Research Ethics Approval Committee for Health at the University of Bath.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are currently available.