Effectiveness of empirically based tackle technique intervention to reduce the in-game risk of injury
Effectiveness of empirically based tackle technique intervention to reduce the in-game risk of injury in healthy sub-elite/elite rugby league and rugby union athletes
University of Sydney
2,000 participants
May 6, 2022
Interventional
Conditions
Summary
No evidence exists on whether different tackle techniques could reduce injury risk such as concussion, breast or shoulder injuries. Our tackle behaviour re-education intervention is empirically-based on our pilot research (Edwards et al., 2021) and the theoretical framework of the Behaviour Change Wheel (D’Lima et al., 2020) to maximise the intervention’s efficacy (Sullivan et al., 2021). Our success to change in-game tackle behaviour will be assessed using industry standard best practice of qualitative video analysis to measure in-game tackle technique proficiency (Aim 1). We will then use gold standard 3D motion analysis to accurately measure tackle-induced forces and 3D tackle technique in the laboratory across a season (Aim 2). This will provide critical mechanistic understanding of how tackle technique influences these impulse forces to the head (i.e. inertial head kinematics), as there is limited 3D tackle motion studies. By using these technologies, we can establish if impulsive forces delivered to the head during a tackle (i.e., concussion risk exposure) can be reduced by re-training in-game and laboratory tackle behaviour. We will focus on Indigenous players, given no published injury research has taken an Indigenous athlete-centred approach despite the higher proportion of National Rugby League (NRL) players identifying as Indigenous/Pasifika (57% vs 3% general population) (League, 2017). We will employ a blended Indigenous pedagogy approach with Western ways of teaching and learning (Yunkaporta, 2009) and will be taught by an Indigenous expert rugby codes coach. The outcomes from this research will enable the translation of our empirically validated results into policy and practice in new coaching manuals on how to teach players to change their tackle behaviour that minimise their head impact exposure and injuries (including breast injuries).
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Interventions
There will be three cohorts: Cohort 1 male rugby league and/or rugby union sporting organisations will be recruited to this study. Cohort 2 junior (boys and girls) representative and pathways rugby league and/or rugby union sporting organisations will be recruited to this study. Cohort 3 women rugby league and/or rugby union sporting organisations will be recruited to this study. Participants will undergo 1 (potentially 2) observational seasons and then 1 intervention season, a maximum total of 3 annual seasons. Video recording (i.e. 2D movement data) of every game will occur across Season 1 and 2 with high speed video cameras and global positioning units. Season 1 and 2 will both involve in-season monitoring of player statistics during each game (tackles, tackle breaks, missed tackles, ineffective tackle) training load (number, duration and rate of perceived exertion of session), and epidemiological data on sport injury and illness. Participants who are suspected of sustaining a concussion will have the SCAT6 performed within 7 days, these results will be compared to their baseline SCAT6 assessment. Players will complete five 3D tackle motion sessions across the two seasons. Season 1 will measure players’ self-selected tackle technique at pre- and post-season. Season 2 will record tackle technique in the pre-season at 0-weeks, 6-weeks post-intervention, and post-season. 3D tackle motion of each participant performing 12 torso tackles will be recorded in each session via 3D motion capture and the instrumented mouthguard. A retro-reflective whole body marker set will be attached to each participants and recorded by 20 motion capture cameras. Retroreflective markers will be attached to the participant using double sided sticky tape and the 3D location of the markers will be the data stored. The kinematic data are required for the analysis in this study; the participants will not be identifiable from the 3D kinematic data. Six high speed cameras will record 2D movement data to calculate laboratory tackle proficiency by video coding characteristic of the participants tackle technique; the participants will be identifiable from the video coding data. Video coding will use a predefined coding matrix of 16 categorical variables in the pre-contact, contact and post-contact phases of the tackle using the 2D movement; this protocol is utilised extensively within this field of research. Female participants will be asked to wear or bring along the bra they most often use during rugby union training and/or games. They will also be given a special crop top to wear over your sports bra, exactly like the GPS crop top they wear during their training and/or games. The crop top is lined with a special wearable sensor to record the impact forces sustained by their breasts when they are performing the tackles. They will be then asked if you have any perceived breast pain during the tackles to their breasts. Female participants will also be complete a breast injuries questionnaire. The magnitude of forces experienced by the breast during these impacts within any sport is yet to be investigated. To ensure our program is safe for females in regards to injuries, including breast injuries, we are measuring breast impact forces. Pre/post intervention design will be employed; the participants will act as their own controls in Season 1 (i.e., observation season) and the tackling intervention will be implemented in Season 2 (i.e., intervention season). Participants will not be provided with any results during Season 1 as this will act as the observation season. In Season 2, participants will undertake the tackle re-education intervention. Training of the tackle technique will be performed by the rugby league/union team coach(es) with coaching and mentoring support from our Indigenous expert coach and skill acquisition expert who will deliver 1x 60-mins introductory tackle session attended by players, coaches, and medical staff to upskill all individuals. A 15-mins tackle drills will occur during the teams’ weekly training sessions, 2x/week for 6 weeks during the pre-season and fortnightly within season. During these sessions, the participants will receive feedback on their tackle technique by the team’s coach(es) and our Indigenous expert coach. The intervention provided will be variable and dependant on the findings of the video coding. Tackle sessions and the drills used are not pre-set but designed on an ad-hoc basis, based upon the findings of the data. Participants will be involved in rugby league/union tackling drills, which can potentially cause physical injury. However, each participant will not be requested to do anything outside of their normal training and match play activities, and therefore participation in this study poses no greater risk than their normal risk of injury in participating in their sport. In fact, the tackling techniques that will be used in this study are considered to be safer, with less of a risk of injury to the ball carrier and the tackler. The length of the intervention is on a seasonal basis, which is variable based upon the number of teams in a competition and the success of the team in graduating through the premiership. The Indigenous pedagogy framework and collaborative engagement with the Wollotuka Institute will facilitate the integration of the research outcomes into the rugby league community by developing new evidence-based coaching manuals for the wider rugby league community that is respectful of the high proportion of Indigenous and Pacifika players in the rugby league community. This research initiative continues to support the NRL’s three core pillars of Health, Learn, and Respect for positive change within the community. The intervention between groups may differ, depending on the skill level and baseline abilities of the teams and players. All interventions will follow the Indigenous pedagogy framework and collaborative engagement as above. The minimum duration of intervention in any given cohort is 6 months and the maximum intervention period in any given cohort is 4 years. Written tackle reports will be provided to coaching staff, as part of the collaborative engagement strategy, with assistance to create clips via our video coding platform to be provided to players for individual feedback.
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ACTRN12624000657527