title: The effectiveness of interventions to reduce neurological injuries in rugby union: a systematic review.
abstract: BACKGROUND
  Rugby is characterized by high-speed collisions among the players that predispose them to injuries, particularly to the head, neck, and spine.
  
  
  OBJECTIVE
  To evaluate the effectiveness of current neurological injury prevention strategies in rugby union.
  
  
  METHODS
  Systematic review in May 2010. We assessed the quality and content of studies that evaluated injury prevention strategies for rugby players and reported on neurological outcomes. We searched OVID Medline, OVID HealthStar, CINAHL, Sport Discus, PubMed, Scholar's Portal Physical Education Index, Web of Science, and the Cochrane Controlled Clinical Trials Register (CENTRAL) and conducted a manual search of the cited literature lists of each included study.
  
  
  RESULTS
  Ten articles are included in the review, with 2 of these assessing both headgear and mouthguards. Four studies reported insignificant reductions in neurological injury with the use of headgear. The results of 4 studies on the effectiveness of mouthguards in preventing neurological injury were inconclusive. Four studies reported significant reductions in neurological injury after the implementation of nationwide multifaceted injury prevention strategies with a focus on education
  
  
  CONCLUSIONS
  There is limited evidence to support the effectiveness of mouthguards and headgear in reducing neurological injuries; however, system-wide, mandatory interventions are useful in reducing neurological injuries in rugby.
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, and Injury Prevention Research Office, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. injuryprevention@smh.toronto.on.ca
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cusimano
authors.forename: Farshad
authors.initials: F
authors.lastname: Nassiri
authors.forename: Youjin
authors.initials: Y
authors.lastname: Chang
mesh_terms: D001930:Brain Injuries / Q000453:epidemiology* / Q000517:prevention & control*; D002170:Canada; D005538:Football / Q000293:injuries*; D006801:Humans; D015995:Prevalence; D011482:Protective Devices / Q000706:statistics & numerical data*; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000517:prevention & control*; D019876:Sports Equipment / Q000706:statistics & numerical data*