Concussion knowledge among South African rugby players
Viljoen, Carel Thomas
MetadataShow full item record
Background: Concussion is one the most frequently reported injuries among rugby players. Potential dangerous long term side-effects such as neurological deficits and chronic traumatic encephalopathy (CTE), explain why concussion is currently an extensively debated topic in the media. The largest part of South Africa’s rugby playing population consists of amateur players. Anecdotal evidence suggest that only a very limited proportion of amateur clubs and schools offer medical assistance at matches or practices, generally due to a lack of funding. BokSmart currently leans towards educating coaches and referees to recognize concussion signs and symptoms and to remove concussed players from the field. However, in a country where field side medical assistance is scarce, the players themselves can play a pivotal role to report possible concussions to their coach or the referee. Currently, no rugby safety management programme is focussing on concussion education among South African rugby players. Further research on concussion knowledge among rugby players are warranted to generate benchmark data needed to inform development and motivate implementation of educational programmes among rugby players, as an addition to the current BokSmart programme. Aims: To evaluate the knowledge on concussion and attitudes/behaviours regarding concussion and return to play (RTP) among South African amateur high school and club rugby players. Methods: A descriptive, cross-sectional study design was used to achieve the aims. The participants (n = 294) were divided into two groups namely; junior amateur high school (JAHS) (n = 216) and senior amateur club (SAC) (n = 78) rugby players. All participants completed the modified Rosenbaum Concussion Knowledge and Attitudes Survey – Student Version (RoCKAS-ST) in order to evaluate their concussion knowledge and attitudes/behaviours regarding concussion and RTP. Descriptive statistics were used to summarise continuous data with means and standard deviations or medians and percentiles as appropriate. Frequencies and percentages were calculated for categorical data while significance was set at p < 0.05 for comparative analyses. Results: The Concussion Knowledge Index (CKI) mean correct answered questions in the JAHS group was 10.46 ± 2.36 (range 3 – 15) of a maximum score of 17 points. Participants of the JAHS on average identified 62.4% of the CKI questions correctly. The CKI mean correct answered questions in the SAC group was 10.17 ± 2.35 (range 4 – 14) of a maximum score of 17 points. Participants of the SAC group on average identified 60.2% of the CKI questions correctly. On average the JAHS participants identified 66.3% of concussion symptoms correctly, while the SAC participants only identified 62.7% correctly. The Concussion Attitudes Index (CAI) mean correct answered questions in the JAHS group was 56.49 ± 8.81 (range 36 – 75) of a maximum score of 90 points. Participants of the JAHS group had a mean safe response of 65.6% when answering the attitude/behaviour regarding concussion and RTP questions. The CAI mean for correct answered questions in the SAC group was 55.88 ± 11.42 (range 20 – 75) of a maximum score of 90 points. Participants of the SAC group had a mean safe response of 67% when answering the attitude/behaviour regarding concussion questions. No statistical significance were found between the mean concussion knowledge scores (p > 0.37) of the JAHS and SAC participants. A p-value of p > 0.98 was noted, also showing no statistical significance between the JAHS and SAC participants’ mean concussion attitude scores. Conclusion: It was concluded that both junior and senior South African amateur rugby players had insufficient knowledge on concussion. The participants’ lack of concussion knowledge were further emphasised during the poor concussion symptom identification. Both groups showed unsafe attitudes/behaviours towards concussion and RTP.