Objective To characterise the incidence, severity and recovery of concussion in a schoolboy rugby population and explore how the results of the Sports Concussion Assessment Tool (SCAT), Cogstate Brief Battery (CBB) and the King-Devick test (K-D test) interact with each other throughout recovery.

Design Prospective cohort study

Setting Rugby union has one of the highest rates of sport related concussion (SRC) of all professional team sports. There is a scarcity of research investigating how concussion affects adolescent rugby players.

Participants Schoolboy rugby players

Outcome Measures Schoolboy rugby players completed a battery of baseline tests in the preseason including the SCAT, CBB and K-D tests and were serially monitored for the duration of the rugby season. Participants diagnosed with SRC during the season attended for post-concussion testing on a weekly basis until clinically recovered. Concussion incidence, mechanism and severity are reported along with post-concussion CBB and K-D test results.

Main Results 135 schoolboy rugby players (16.7 ± 0.82y) participated in the study. There were 18 SRCs in 16 participants. The incidence of concussion was 9/1000 player hours. Mean duration of clinical recovery was 20 days. CBB and K-D tests correlated poorly with clinical opinion and produced high false negative rates (0.58 and 0.52 respectively).

Conclusions This study reports a relatively high match injury incidence of concussion for an adolescent population. Analysis of clinical recovery with the CBB and K-D test revealed relatively poor diagnostic accuracy and would suggest that these tools should not be used in isolation for monitoring SRC recovery in adolescents.