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First Round Abstract Submissions
11) Risk Reduction/Prevention
11.4 Clinically important reduction in concussion rate following lowering of the legal tackle height in collegiate rugby union
  1. James Brown1,2,
  2. Van Tonder Riaan1,2,
  3. Starling Lindsay1,2,3,
  4. Viviers Pierre1,2,
  5. Hendricks Sharief5,6,7,
  6. Kraak Wilbur7,
  7. Stokes Keith3,4,
  8. Surmon Sean1,2,9,
  9. Derman Elton Wayne1,2,
  10. Jordaan Esme10,11
  1. 1Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
  2. 2IOC Research Centre, Pretoria, South Africa
  3. 3Department for Health, University of Bath, Bath, UK
  4. 4Rugby Football Union, London, UK
  5. 5Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
  6. 6Health, Physical Activity, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
  7. 7Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Cape Town, South Africa
  8. 7Department of Sports Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
  9. 9Maties Sport, Stellenbosch University, Stellenbosch, South Africa
  10. 10Biostatistics Unit, Medical Research Council, Cape Town, South Africa
  11. 11Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa

Abstract

Objective Determine the change in concussion incidence in collegiate rugby union following a lowering of the legal tackle height.

Design Cohort study with existing tackle laws in 2018 (‘standard’) and a tackle height law variation in 2019 (‘lowered’).

Setting 2018 and 2019 collegiate rugby seasons.

Participants All male rugby players participating in the 2018 and 2019 seasons. All injuries were reported by campus medical staff using standardised methods.

Interventions (or Assessment of Risk Factors) Tackle law variation: maximum legal height was reduced from the shoulder to the armpit of the player being tackled.

Outcome Measures Dependent variable = concussion incidence (injury count/match exposure time) with 95% confidence intervals. Incidence rate ratios (IRR) were calculated by dividing ‘lowered’ by ‘standard’ rates. Concussion mechanism was also captured.

Main Results There were 27 concussions and 2,910 match hours and 21 concussions in 3,415 match hours in the ‘standard’ and ‘lowered’ seasons, respectively (IRR=0.66, 95%CI: 0.37–1.17). This incidence was significantly lower in the last third of the ‘lowered’ season (IRR=0.14, 95% CIs: 0.05–0.45). The most common concussion mechanisms in the ‘standard’ season were tackling (33%), accidental collisions (30%) and being tackled (11%); and tackling (43%), being tackled (24%) and the ruck (33%) in the ‘lowered’ season.

Conclusions Concussion incidence reduced by 34% after introducing a tackle height law variation. Although this reduction was not statistically significant, it can be considered clinically important. The unexpected increase in concussions to players being tackled warrants further investigation, but could be explained by misreported ‘accidental collisions’ in the ‘standard’ season.

https://doi.org/10.1136/bjsports-2023-concussion.145

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