Tucker Ross, Hester Ben, Hendricks Sharief, Brown James, Falvey Éanna C
Institute of Sport and Exercise Medicine, Department of Exercise, University of Stellenbosch, Stellenbosch, South Africa.
World Rugby, Dublin, Ireland.
BMJ Open Sport Exerc Med. 2024 Jun 28;10(2):e001932. doi: 10.1136/bmjsem-2024-001932. eCollection 2024.
Tackles making contact above the sternum increase concussion and head injury assessment (HIA) risk in Rugby Union. The sport has introduced harsher sanctions to change tackler behaviours to reduce this risk. This increased high tackle sanction numbers, though it is unknown whether sanction severity is associated with injury risk.
The sanction decision made by match officials for tackles resulting in 157 HIA1 removals, of which 91 were confirmed concussions, was evaluated. The propensity of sanction types, ranging from no foul play to red card, was compared after calculating concussion and HIA1 numbers per 1000 tackles of each sanction, using total tackle number of each sanction type from one season of two elite professional competitions.
HIA1 removal and concussion risk increased as sanction severity increased. Red-carded tackles were 271.5 (95% CI 143.8 to 512.6) times more likely to result in concussions than legal tackles. Tacklers and ball carriers were more likely to experience concussions from sanctioned high tackles, with tackler risk 28.5 (95% CI 13.5 to 59.9) times higher for sanctioned high tackles compared with legal tackles, and ball carrier risk elevated 133.7-fold (95% CI 65.5 to 272.8) after sanctioned high tackles.
Sanctioned high tackles significantly increase concussion and HIA1 risk to both tacklers and ball carriers. Current decision-making frameworks that guide sanction decisions do identify tackle behaviours that elevate clinical risk. Both tacklers and ball carriers would be less likely to experience concussions and head injuries if the frequency of illegal high tackles is decreased.
在英式橄榄球联盟中，胸部以上的擒抱动作会增加脑震荡和头部损伤评估（HIA）风险。该运动已引入更严厉的制裁措施，以改变擒抱者的行为，降低这种风险。尽管尚不清楚制裁的严厉程度是否与受伤风险相关，但这增加了高擒抱制裁的数量。
评估了比赛官员对导致157次HIA1判罚下场的擒抱动作所做出的制裁决定，其中91次被确认为脑震荡。在计算每种制裁每1000次擒抱动作中的脑震荡和HIA1数量后，使用两个精英职业比赛一个赛季中每种制裁类型的总擒抱次数，比较了从无违规动作到红牌等不同制裁类型的倾向。
随着制裁严厉程度的增加，HIA1判罚下场和脑震荡风险也随之增加。被罚红牌的擒抱动作导致脑震荡的可能性是合法擒抱动作的271.5倍（95%置信区间143.8至512.6）。擒抱者和持球队员在被制裁的高擒抱动作中更易发生脑震荡，与合法擒抱动作相比，被制裁的高擒抱动作中擒抱者的风险高28.5倍（95%置信区间13.5至59.9），持球队员的风险在被制裁的高擒抱动作后升高了133.7倍（95%置信区间65.5至272.8）。
被制裁的高擒抱动作会显著增加擒抱者和持球队员的脑震荡和HIA1风险。当前指导制裁决定的决策框架确实能识别出会增加临床风险的擒抱动作。如果非法高擒抱动作的频率降低，擒抱者和持球队员发生脑震荡和头部损伤的可能性都会降低。
