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. 2024 Apr 17;10(1):43.
doi: 10.1186/s40798-024-00696-7.

Tackle Risk Factors for Head Injury Assessments (HIAs) in Sub-Elite Rugby League and Recommendations for Prevention: Head Contacts from Upright Tackles Increase the HIA Risk to Both Ball Carrier and Tackler

Martin A Lang  1 , Ross Tucker  2 , Suzi Edwards  3 , Grant L Iverson  4   5   6 , Andrew J Gardner  7
Affiliations

Tackle Risk Factors for Head Injury Assessments (HIAs) in Sub-Elite Rugby League and Recommendations for Prevention: Head Contacts from Upright Tackles Increase the HIA Risk to Both Ball Carrier and Tackler

Martin A Lang et al. Sports Med Open. .

Abstract

Background: The rugby league tackle has been identified as the game event with the greatest propensity for a clinically diagnosed concussion. This study aims to replicate the work conducted in professional rugby league and rugby union by examining Head Injury Assessment (HIA) events to determine the associated tackle characteristics that increase concussion risk in sub-elite rugby league players. This comparison between competition levels is important due to the less developed physiological and tackle proficiency characteristics of sub-elite rugby league players and the fewer resources available for an on-field diagnosis, compared to the elite level of the sport.

Results: Tackles resulting in Head Injury Assessments (HIAs, n = 131) and 2,088 tackles that did not result in a head injury were identified and coded from one season of the 2019 Queensland Cup. The body position of both ball carrier and tackler, tackle height, and body contact areas were evaluated. The propensity for tacklers to undergo a head injury assessment was 1.49 HIAs per 1,000 tackles, equating to a 2.5-fold higher risk than that of the ball carrier (0.59 HIAs per 1,000 tackles). The risk for an HIA was 2.75-fold greater when the tackler was upright (2.89 HIAs per 1,000 tackles) compared to a bent-at-the-waist tackler (1.05 HIAs per 1,000 tackles). The greatest risk for the tackler and ball carrier sustaining an HIA occurred when the tackle height was high, with head-to-head contact having the greatest propensity for an HIA (44.37 HIAs per 1,000 tackles). HIA risk was also greater for both players when the ball carrier did not employ an evasion strategy (3.73 HIAs per 1,000 tackles).

Conclusions: The study replicates results from research in elite rugby league and rugby union. A combination of higher head contact/proximity and upright body position significantly increase an HIA risk. Tackler head position and ball carrier evasion behaviours also affect risk, suggesting that injury prevention strategies designed to reduce tackle height and improve tackle technique by focusing on head position, body position, and in a novel finding, ball carrier evasion, may reduce head injury risk in sub-elite rugby league players.

Keywords: Head impact events; Head injury assessment; Head injury prevention; Mild traumatic brain injury; Tackle events.

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Conflict of interest statement

Martin Lang and Suzi Edwards, Ph.D. have nothing to disclose.

Ross Tucker, Ph.D. is a Sports Scientist consultant for World Rugby.

Grant Iverson, Ph.D. has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs (including athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has received research support from the Harvard Integrated Program to Protect and Improve the Health of NFLPA Members, and grant support from the National Football League. He serves as a scientific advisor for Sway Operations, LLC, Highmark, Inc., and for NanoDX®.

Andrew Gardner, Ph.D. has a clinical practice in neuropsychology involving individuals who have sustained sport-related concussion (including current and former athletes). He has been a contracted concussion consultant to Rugby Australia since July 2016. He has received travel funding or been reimbursed by professional sporting bodies, and commercial organisations for discussing or presenting sport-related concussion research at meetings, scientific conferences, workshops, and symposiums. He has previously been a scientific advisor to HitIQ Ltd. Previous grant funding includes the NSW Sporting Injuries Committee, the Brain Foundation (Australia), an Australian-American Fulbright Commission Postdoctoral Award, an NHMRC early research career fellowship, a Hunter New England Local Health District, Research, Innovation and Partnerships Health Research & Translation Centre and Clinical Research Fellowship Scheme, and the Hunter Medical Research Institute (HMRI), supported by Jennie Thomas, and the HMRI, supported by Anne Greaves. He has current salary and research funding through an NHMRC Investigator grant. He has received unrestricted philanthropic support from the National Rugby League (NRL) and the Nick Tooth Foundation.

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References

    1. Gardner AJ, Iverson GL, Edwards S, Tucker R. A case–control study of tackle-based Head Injury Assessment (HIA) risk factors in the National Rugby League. Sports Med Open. 2021;7:84. doi: 10.1186/s40798-021-00377-9. - DOI - PMC - PubMed
    1. Gabbett TJ. Physiological characteristics of junior and senior rugby league players. Br J Sports Med. 2002;36:334–9. doi: 10.1136/bjsm.36.5.334. - DOI - PMC - PubMed
    1. Gardner AJ, Iverson GL, Quinn TN, Makdissi M, Levi CR, Shultz SR, et al. A preliminary video analysis of concussion in the National Rugby League. Brain Inj. 2015;29:1182–5. doi: 10.3109/02699052.2015.1034179. - DOI - PubMed
    1. Muchiri WA, Olutende M, Kweyu IW, Concussion. A Growing Concern in the Rugby Fraternity. American Journal of Sports Science and Medicine [Internet]. 2019;7:10–5. Available from: http://pubs.sciepub.com/ajssm/7/1/2.
    1. Tucker R, Raftery M, Kemp S, Brown J, Fuller G, Hester B, et al. Risk factors for head injury events in professional rugby union: a video analysis of 464 head injury events to inform proposed injury prevention strategies. Br J Sports Med. 2017;51:1152–7. doi: 10.1136/bjsports-2017-097895. - DOI - PubMed

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