![]() This response also highlighted the key issues of differences in reporting of injury rates across youth rugby, making comparisons between studies challenging. highlighted that in the youth game, “neither the incidence nor severity of injury have been thoroughly identified and understood, and thus nor have the specific mechanisms and risk factors for injury”. Furthermore, there have been calls for a ban on tackling in the youth game in the United Kingdom. This was exemplified in 2019 by the banning of the sport (temporarily), in Nova Scotia, Canada. Despite the global popularity of the sport and its recent growth, there have been significant safety concerns regarding injury and concussion rates, particularly for youth. Rugby Union is a collision team sport that is played by nearly 10 million people. ![]() Targeting primary prevention and stakeholder education remain key strategies in the prevention, recognition and management of injuries and concussions in youth rugby. ConclusionĪ focus on high-quality risk factor and primary prevention evaluation should be considered in future studies. The primary limitations included a broad range of injury definitions ( n = 9) and rate denominators ( n = 11) used, as well as a limited number of studies which could be included in the meta-analysis for females ( n = 2). The prevention strategy with the most promising evidence was neuromuscular training. Primary injury prevention strategies were the focus of only eight studies and included law changes ( n = 2), equipment ( n = 4), education ( n = 1) and training ( n = 1). The risk factors with the strongest evidence were higher levels of play and increasing age. Median time loss was 21 days for males and 17 days for females. The tackle was the most common event associated with injury in matches (55% male, 71% females). The most common injury type was ligament sprain (males) and concussion (females). The most common injury site was lower extremity (males) and the head/neck (females). Sixty-nine studies were included in this SR. ![]() Meta-analyses were conducted using a DerSimonian Laird random effect model for each age group and sex. Each study was assessed for risk of bias using the Downs and Black quality assessment tool. The full search strategy and list of sources are available and pre-registered on PROSPERO (Ref: CRD42020208343). Exclusion criteria included non-peer-reviewed grey literature, conference abstracts, case studies, previous systematic reviews and studies not written in English. To be included, studies were required to report either rates, risk factors or prevention strategies in youth rugby and to have a randomised controlled trial, quasi-experimental, cohort, case control, or ecological study design. The objective of this systematic review (SR) and meta-analysis was to investigate injury and concussion rates, risk factors and primary prevention strategies in youth rugby. Given this, a review of injury rates, risk factors and prevention strategies is required across different youth age groups as well as in males and females. Despite this, significant concerns have been raised regarding the sport’s safety, particularly in youth players.
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