The effectiveness of interventions to reduce neurological injuries in rugby union: a systematic review

Neurosurgery. 2010 Nov;67(5):1404-18; discussion 1418. doi: 10.1227/NEU.0b013e3181f209f1.


Background: Rugby is characterized by high-speed collisions among the players that predispose them to injuries, particularly to the head, neck, and spine.

Objective: To evaluate the effectiveness of current neurological injury prevention strategies in rugby union.

Methods: Systematic review in May 2010. We assessed the quality and content of studies that evaluated injury prevention strategies for rugby players and reported on neurological outcomes. We searched OVID Medline, OVID HealthStar, CINAHL, Sport Discus, PubMed, Scholar's Portal Physical Education Index, Web of Science, and the Cochrane Controlled Clinical Trials Register (CENTRAL) and conducted a manual search of the cited literature lists of each included study.

Results: Ten articles are included in the review, with 2 of these assessing both headgear and mouthguards. Four studies reported insignificant reductions in neurological injury with the use of headgear. The results of 4 studies on the effectiveness of mouthguards in preventing neurological injury were inconclusive. Four studies reported significant reductions in neurological injury after the implementation of nationwide multifaceted injury prevention strategies with a focus on education

Conclusion: There is limited evidence to support the effectiveness of mouthguards and headgear in reducing neurological injuries; however, system-wide, mandatory interventions are useful in reducing neurological injuries in rugby.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Brain Injuries / epidemiology*
  • Brain Injuries / prevention & control*
  • Canada
  • Football / injuries*
  • Humans
  • Prevalence
  • Protective Devices / statistics & numerical data*
  • Spinal Cord Injuries / epidemiology*
  • Spinal Cord Injuries / prevention & control*
  • Sports Equipment / statistics & numerical data*