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Effectiveness of the Activate injury prevention exercise programme to prevent injury in schoolboy rugby union
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  1. Craig Barden1,2,
  2. Matthew V Hancock1,
  3. Keith A Stokes1,3,
  4. Simon P Roberts1,
  5. Carly D McKay1,4
  1. 1 Department for Health, University of Bath, Bath, UK
  2. 2 School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
  3. 3 Rugby Football Union, Twickenham, UK
  4. 4 Centre for Motivation and Health Behaviour Change, University of Bath, Bath, UK
  1. Correspondence to Craig Barden, Department for Health, University of Bath, Bath BA2 7AY, UK; cb2171{at}bath.ac.uk

Abstract

Objective The efficacious Activate injury prevention exercise programme has been shown to prevent injuries in English schoolboy rugby union. There is now a need to assess the implementation and effectiveness of Activate in the applie setting.

Methods This quasi-experimental study used a 24-hour time-loss injury definition to calculate incidence (/1000 hours) and burden (days lost/1000 hours) for individuals whose teams adopted Activate (used Activate during season) versus non-adopters. The dose-response relationship of varying levels of Activate adherence (median Activate sessions per week) was also assessed. Player-level rugby exposure, sessional Activate adoption and injury reports were recorded by school gatekeepers. Rate ratios (RR), adjusted by cluster (team), were calculated using backwards stepwise Poisson regression to compare rates between adoption and adherence groups.

Results Individuals in teams adopting Activate had a 23% lower match injury incidence (RR 0.77, 95% CI 0.55 to 1.07), 59% lower training injury incidence (RR 0.41, 95% CI 0.17 to 0.97) and 26% lower match injury burden (95% CI 0.46 to 1.20) than individuals on non-adopting teams. Individuals with high Activate adherence (≥3 sessions per week) had a 67% lower training injury incidence (RR 0.33, 95% CI 0.12 to 0.91) and a 32% lower match injury incidence (RR 0.68, 95% CI 0.50 to 0.92) than individuals with low adherence (<1 session per week). While 65% of teams adopted Activate during the season, only one team used Activate three times per week, using whole phases and programme progressions.

Conclusion Activate is effective at preventing injury in English schoolboy rugby. Attention should focus on factors influencing programme uptake and implementation, ensuring Activate can have maximal benefit.

  • Rugby
  • Athletic Injuries
  • Preventive Medicine
  • Adolescent

Data availability statement

No data are available. All publicly available data are available in the manuscript or online supplemental files. It is not possible to share further information, individual injury and exposure data, due to its confidential nature and the age of the participants.

http://dx.doi.org/10.1136/bjsports-2021-105170

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    Data availability statement

    No data are available. All publicly available data are available in the manuscript or online supplemental files. It is not possible to share further information, individual injury and exposure data, due to its confidential nature and the age of the participants.

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    Footnotes

    • Twitter @cigney, @drkeithstokes, @drsimonroberts, @Dr_CMcKay

    • Contributors CB, CDM and KAS devised the initial concept of the study, with MVH and SPR providing advice and guidance. CB and MVH completed all the data collection and data cleaning. CB analysed all the data. CB wrote all manuscript drafts, with critical appraisal from CDM and KAS. All authors approved the final version of the manuscript ready for submission. CB is listed as the guarantor for the study.

    • Funding CB completed this study as part of his PhD, which is funded by the Rugby Football Union.

    • Competing interests KAS is the medical research lead for the Rugby Football Union.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.