title: Concussive Injuries in Rugby 7s: An American Experience and Current Review.
abstract: There is a comparative lack of concussion incidence data on the new Olympic sport Rugby 7s. This study aimed to determine the incidence (number of concussions per 1000 playing hours [ph]), mean and median severity (days absence), and cause of concussive injuries.
  
  
  
  This is a prospective epidemiology study, amateur to elite/national candidate, male (9768) and female (3876) players in USA Rugby sanctioned tournaments, compliant with the international consensus statement for studies in rugby union.
  
  
  
  Concussions in US Rugby 7s were 7.7/1000 ph (n = 67). Women encountered concussions at 8.1/1000 ph, and men at 7.6/1000 ph (risk ratio [RR] = 1.10, P = 0.593). Elite/national-level players encountered concussions at higher rates (18.3/1000 ph) than lower levels (6.4/1000 ph; RR = 5.48, P < 0.001). Nonelite backs had higher concussive injury rates compared with forwards (7.7/1000 ph; 3.6/1000 ph; RR = 1.28, P = 0.024). Women missed 36.7 d absence from play, meanwhile men missed 27.9 d (P = 0.245). Retrospective history recall reflected previous concussive injuries occurred in 43% of the current study's cohort; of these, 57% encountered multiple concussions within 1 yr. The incidence of repetitive concussions was not statistically different between genders (RR = 1.09, P = 0.754). Most concussions occurred from tackles (63%) and collisions (24%) (P = 0.056).
  
  
  
  Sports-related concussions occurred with frequency among US amateur Rugby 7s players. US Elite tournament players sustained concussions at much higher rates than international male Rugby 7s counterparts. A substantial portion of US players who sustained a concussion had previous concussion injuries. Given the high rate of concussion, including repetitive concussive injuries, US Rugby 7s may benefit from concussion prevention measures similar to other contact sports such as instruction on proper tackling techniques, in-game and postgame medical assessment, and a standardized return-to-play protocol.
authors.affiliation: 1Rugby Research and Injury Prevention Group, New York, NY; 2USA Rugby Empire Geographic Union RFU, New York, NY; 3Rugby Codes Research Group, Sports Performance Research Institute, Auckland University of Technology, Auckland, NEW ZEALAND; 4Northeast Rugby Academy, USOC-Sanctioned Olympic Development Program, New York, NY; 5Comparative Orthopaedic Laboratory, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO; 6Steinhardt School of Culture, Education and Human Development, New York University, New York, NY; 7Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA; 8Department of Neurosurgery, Boston University School of Medicine, Boston, MA; 9Department of Neurosurgery, Emerson Hospital, Concord, MA; 10Department of Surgery, Emerson Hospital, Concord, MA; 11Service of Sports Medicine, Emerson Hospital, Concord, MA; 12Neurologic Sports Injury Center, Brigham and Women's Hospital, Boston, MA; 13Concussion Legacy Foundation, Waltham, MA; 14World Rugby, Independent Concussion Group, Dublin, Ireland; 15Advanced Therapeutics Physical Therapy, Inc., Florence, MA; 16Department of Physical Therapy, Seton Hall University, South Orange Village, NJ; 17New York University, Global Institute of Public Health, New York, NY; 18Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY; 19National Basketball Association, New York Knickerbockers New York, NY; and 20USA Basketball, Colorado Springs, CO.
authors.forename: Victor
authors.initials: V
authors.lastname: Lopez
authors.forename: Richard
authors.initials: R
authors.lastname: Ma
authors.forename: Meryle G
authors.initials: MG
authors.lastname: Weinstein
authors.forename: Robert C
authors.initials: RC
authors.lastname: Cantu
authors.forename: Laurel S D
authors.initials: LS
authors.lastname: Myers
authors.forename: Nisha S
authors.initials: NS
authors.lastname: Nadkar
authors.forename: Christian
authors.initials: C
authors.lastname: Victoria
authors.forename: Answorth A
authors.initials: AA
authors.lastname: Allen
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D001924:Brain Concussion / Q000453:epidemiology*; D005260:Female; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014481:United States; D055815:Young Adult