七人制橄榄球中的脑震荡损伤：美国的经验与当前综述
Concussive Injuries in Rugby 7s: An American Experience and Current Review.
作者信息
Lopez Victor, Ma Richard, Weinstein Meryle G, Cantu Robert C, Myers Laurel S D, Nadkar Nisha S, Victoria Christian, Allen Answorth A
机构信息
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.
出版信息
Med Sci Sports Exerc. 2016 Jul;48(7):1320-30. doi: 10.1249/MSS.0000000000000892.
PURPOSE
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
目的
新的奥林匹克运动项目七人制橄榄球的脑震荡发病率数据相对较少。本研究旨在确定发病率（每1000比赛小时[ph]的脑震荡次数）、平均和中位数严重程度（缺赛天数）以及脑震荡损伤的原因。
方法
这是一项前瞻性流行病学研究，研究对象为美国橄榄球协会批准赛事中的业余至精英/国家候选级别、男性（9768名）和女性（3876名）球员，符合橄榄球联盟研究的国际共识声明。
结果
美国七人制橄榄球的脑震荡发病率为7.7/1000 ph（n = 67）。女性的脑震荡发病率为8.1/1000 ph，男性为7.6/1000 ph（风险比[RR]=1.10，P = 0.593）。精英/国家级别的球员脑震荡发病率（18.3/1000 ph）高于低级别球员（6.4/1000 ph；RR = 人口统计学和临床特征5.48，P < 0.001）。非精英后卫的脑震荡损伤率高于前锋（7.7/1000 ph；3.6/1000 ph；RR = 1.28，P = 0.024）。女性缺赛36.7天，而男性缺赛27.9天（P = 0.245）。回顾性病史回忆显示，本研究队列中有43%的人曾有过脑震荡损伤；其中，57%的人在1年内遭遇多次脑震荡。重复性脑震荡的发病率在性别之间无统计学差异（RR = 1.09，P = 0.754）。大多数脑震荡发生于擒抱（63%）和碰撞（24%）（P = 0.056）。
结论
在美国业余七人制橄榄球运动员中，与运动相关的脑震荡频繁发生。美国精英赛事球员的脑震荡发生率远高于国际七人制橄榄球男性球员。很大一部分遭受脑震荡的美国球员曾有过脑震荡损伤。鉴于脑震荡发生率较高，包括重复性脑震荡损伤，美国七人制橄榄球可能会从类似于其他接触性运动的脑震荡预防措施中受益，如正确擒抱技术指导、赛中及赛后医学评估以及标准化的重返赛场方案。
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