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Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trial [with consumer summary]
Hislop MD, Stokes KA, Williams S, McKay CD, England ME, Kemp SPT, Trewartha G
British Journal of Sports Medicine 2017 Aug;51(15):1140-1146
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Injury risk in youth rugby has received much attention, highlighting the importance of establishing evidence-based injury reduction strategies. AIM: To determine the efficacy of a movement control exercise programme in reducing injuries in youth rugby players and to investigate the effect of programme dose on injury measures. METHODS: In a cluster-randomised controlled trial, 40 independent schools (118 teams, 3,188 players aged 14 to 18 years) were allocated to receive either the intervention or a reference programme, both of which were to be delivered by school coaches. The intervention comprised balance training, whole-body resistance training, plyometric training, and controlled rehearsal of landing and cutting manoeuvres. Time-loss (> 24 hours) injuries arising from school rugby matches were recorded by coaches and medical staff. RESULTS: 441 time-loss match injuries (intervention 233; control 208) were reported across 15,938 match exposure-hours (intervention 9,083; control 6,855). Intention-to-treat results indicated unclear effects of trial arm on overall match injury incidence (rate ratio (RR) 0.85, 90% confidence limits 0.61 to 1.17), although clear reductions were evident in the intervention arm for concussion incidence (RR 0.71, 0.48 to 1.05). When trial arm comparisons were limited to teams who had completed three or more weekly programme sessions on average, clear reductions in overall match injury incidence (RR 0.28, 0.14 to 0.51) and concussion incidence (RR 0.41, 0.17 to 0.99) were noted in the intervention group. CONCLUSION: A preventive movement control exercise programme can reduce match injury outcomes, including concussion, in schoolboy rugby players when compared with a standardised control exercise programme, although to realise the greatest effects players should complete the programme at least three times per week.
Reproduced with permission from the BMJ Publishing Group.

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