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Int J Sports Med 2021; 42(10): 930-935
DOI: 10.1055/a-1345-9163
Training & Testing

Padded Headgear does not Reduce the Incidence of Match Concussions in Professional Men’s Rugby Union: A Case-control Study of 417 Cases

Keith A. Stokes 
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
2   Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great Britain and Northern Ireland
,
Matthew Cross
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
3   Rugby Department, Premiership Rugby, Twickenham, United Kingdom of Great Britain and Northern Ireland
,
Sean Williams 
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Carly McKay
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Brent E. Hagel
4   Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
5   Department of Pediatrics, University of Calgary Cumming School of Medicine, Calgary, Canada
6   O’Brien Institute of Public Health, University of Calgary Cumming School of Medicine, Calgary, Canada
7   Alberta Children’s Hospital Research Institute, University of Calgary Cumming School of Medicine, Calgary, Canada
,
Stephen W. West 
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Simon Paul Roberts
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Ricardo T. Sant’Anna
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Edward Morrison
1   Department for Health, University of Bath, Bath, United Kingdom of Great Britain and Northern Ireland
,
Simon Kemp
2   Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great Britain and Northern Ireland
8   Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine Faculty of Epidemiology and Public Health, London, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations
Funding This work was funded by the Rugby Football Union and Premiership Rugby.
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Abstract

Concussion is the most common match injury in rugby union. Some players wear padded headgear, but whether this protects against concussion is unclear. In professional male rugby union players, we examined: (i) the association between the use of headgear and match concussion injury incidence, and (ii) whether wearing headgear influenced time to return to play following concussion. Using a nested case-control within a cohort study, four seasons (2013–2017) of injury data from 1117 players at the highest level of rugby union in England were included. Cases were physician-diagnosed concussion injuries. Controls were other contact injuries (excluding all head injuries). We determined headgear use by viewing video footage. Sixteen percent of cases and controls wore headgear. Headgear use had no significant effect on concussion injury incidence (adjusted odds ratio=1.05, 95% CI: 0.71–1.56). Median number of days absent for concussion whilst wearing headgear was 8 days, compared with 7 days without headgear. Having sustained a concussion in the current or previous season increased the odds of concussion more than four-fold (odds ratio=4.55, 95% CI: 3.77–5.49). Wearing headgear was not associated with lower odds of concussions or a reduced number of days' absence following a concussion.

Key words

traumatic brain injury - mTBI - sports injury - injury prevention - equipment - concussion severity


Publication History

Received: 26 August 2020

Accepted: 15 December 2020

Article published online:
19 February 2021

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