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Team illness prevention strategy (TIPS) is associated with a 59% reduction in acute illness during the Super Rugby tournament: a control–intervention study over 7 seasons involving 126 850 player days
  1. Martin Schwellnus1,2,
  2. Charl Janse van Rensburg3,
  3. Helen Bayne4,
  4. Wayne Derman2,5,
  5. Clint Readhead6,
  6. Rob Collins7,
  7. Alan Kourie8,
  8. Jason Suter9,
  9. Org Strauss10,
  10. Nicola Sewry11,
  11. Esme Jordaan3
  1. 1Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  2. 2Research Centre, International Olympic Committee, Pretoria, South Africa
  3. 3Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa
  4. 4Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Department of Physiology, University of Pretoria, Pretoria, South Africa
  5. 5Institute for Sport and Exercise Medicine (ISEM), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
  6. 6Medical Department, South African Rugby Union, Cape Town, South Africa
  7. 7Medical Department, Golden Lions Rugby Union, Johannesburg, South Africa
  8. 8Medical Department, Sharks Rugby Union, Durban, South Africa
  9. 9Medical Department, Stormers Rugby Union, Cape Town, South Africa
  10. 10Medical Department, Blue Bulls Rugby Union, Pretoria, South Africa
  11. 11Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa
  1. Correspondence to Professor Martin Schwellnus, Sport, Exercise Medicine and Lifestyle Institute (SEMLI) and Section Sports Medicine, University of Pretoria, Faculty of Health Sciences, Pretoria 0186, South Africa; mschwell{at}iafrica.com

Abstract

Objectives To determine whether a team illness prevention strategy (TIPS) would reduce the incidence of acute illness during the Super Rugby tournament.

Methods We studied 1340 male professional rugby union player seasons from six South African teams that participated in the Super Rugby tournament (2010–2016). Medical staff recorded all illnesses daily (126 850 player days) in a 3-year control (C: 2010–2012; 47 553 player days) and a 4-year intervention (I: 2013–2016; 79 297 player days) period. A five-element TIPS was implemented in the I period, following agreement by consensus. Incidence rate (IR: per 1000 player days; 95% CI) of all acute illnesses, illness by main organ system, infectious illness and illness burden (days lost due to illness per 1000 player days) were compared between C and I period.

Results The IR of acute illness was significantly lower in the I (5.5: 4.7 to 6.4) versus the C period (13.2: 9.7 to 18.0) (p<0.001). The IR of respiratory (C=8.6: 6.3 to 11.7; I=3.8: 3.3 to 4.3) (p<0.0001), digestive (C=2.5: 1.8 to 3.6; I=1.1: 0.8 to 1.4) (p<0.001), skin and subcutaneous tissue illness (C=0.7: 0.4 to 1.4; I=0.3: 0.2 to 0.5) (p=0.0238), all infections (C=8.4: 5.9 to 11.9; I=4.3: 3.7 to 4.9) (p<0.001) and illness burden (C=9.2: 6.8 to 12.5; I=5.7: 4.1 to 7.8) (p=0.0314) were significantly lower in the I versus the C period.

Conclusion A TIPS during the Super Rugby tournament was associated with a lower incidence of all acute illnesses (59%), infectious illness (49%) and illness burden (39%). Our findings may have important clinical implications for other travelling team sport settings.

  • rugby
  • illness
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Footnotes

  • Contributors MS: responsible for the overall content as guarantor, study concept, study planning, data collection, data interpretation, manuscript (first draft), manuscript editing, facilitating funding. CJvR: data interpretation, manuscript drafting and editing. HB: data interpretation, manuscript (first draft), manuscript editing. WD: study planning, data collection, data interpretation, manuscript editing. CR: data interpretation, manuscript editing, facilitating funding. RC: data collection, data interpretation, manuscript editing. AK: data collection, data interpretation, manuscript editing. JS: data collection, data interpretation, manuscript editing. OS: data collection, data interpretation, manuscript editing. NS: data interpretation, manuscript editing. EJ: study planning, data analysis including statistical analysis, data interpretation, manuscript editing.

  • Competing interests CR is the chairman of the South Africa Rugby Football Union Medical Committee.

  • Patient consent for publication Obtained.

  • Ethics approval Research ethics committees of the University of Cape Town (REC nos. 008/2011 and 736/2013) and the University of Pretoria (432/2015).

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

  • Data availability statement No data are available. All data relevant to the study are included in the article or uploaded as online supplementary information.

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