Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study

doi:10.1136/bmj.39185.605914.AE

BMJ, doi: 10.1136/bmj.39185.605914.AE, (Published 18 May 2007)

RESEARCH

Effect of nationwide injury prevention programme on serious spinal injuries in New Zealand rugby union: ecological study

Kenneth L Quarrie ¹^*, Simon M Gianotti ², Will G Hopkins ³, Patria A Hume ⁴

¹ Research & Injury Prevention, New Zealand Rugby Union, PO Box 2172, Wellington, New Zealand
² Sport & Road, Accident Compensation Corporation, Wellington
³ Exercise Science, Institute of Sport & Recreation Research New Zealand, Faculty of Health and Environmental Science, AUT University, Auckland 1020, New Zealand
⁴ Institute of Sport & Recreation Research New Zealand

^* Correspondence to: ken.quarrie{at}nzrugby.co.nz.

Objective To investigate the effect of RugbySmart, a nationwideeducational injury prevention programme, on the frequency ofspinal cord injuries.

Design Ecological study.

Setting New Zealandrugby union.

Participants Population at risk of injury comprisedall New Zealand rugby union players.

Intervention From 2001,all New Zealand rugby coaches and referees have been requiredto complete RugbySmart, which focuses on educating rugby participantsabout physical conditioning, injury management, and safe techniquesin the contact phases of rugby.

Main outcome measures Numbersof all spinal injuries due to participation in rugby union resultingin permanent disablement in 1976-2005, grouped into five yearperiods; observed compared with predicted number of spinal injuriesin 2001-5.

Results Eight spinal injuries occurred in 2001-5,whereas the predicted number was 18.9 (relative rate=0.46, 95%confidence interval 0.19 to 1.14). Only one spinal injury resultedfrom scrums over the period; the predicted number was 9.0 (relativerate=0.11, 0.02 to 0.74). Corresponding observed and predictedrates for spinal injuries resulting from other phases of play(tackle, ruck, and maul) were 7 and 9.0 (relative rate=0.83,0.29 to 2.36).

Conclusions The introduction of the RugbySmartprogramme coincided with a reduction in the rate of disablingspinal injuries arising from scrums in rugby union. This studyexemplifies the benefit of educational initiatives in injuryprevention and the need for comprehensive injury surveillancesystems for evaluating injury prevention initiatives in sport.

(Accepted 5 April 2007)

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