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NZ–RugbyHealth Study: Current Postural Control Ability of Former Rugby Union and Non-contact Sport Players

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Abstract

Background

Players in contact sports frequently experience mild traumatic brain (concussion) injuries (TBI). While there are known disruptions to balance following acute head trauma, it is uncertain if sport-related concussion injuries have a lasting impact on postural control.

Aim

To assess postural control in retired rugby players in comparison to retired non-contact sport players, and to evaluate any association with self-reported sport-related concussion history.

Methods

Using a cross-sectional design, 75 players in the NZ–RugbyHealth study from three sports groups (44 ± 8 years; 24 elite rugby, 30 community rugby, 21 non-contact sport) took part in this study. The SMART EquiTest® Balance Master was used to assess participant’s ability to make effective use of visual, vestibular and proprioceptive information using standardised tests. Postural sway was also quantified using centre of pressure (COP) path length. The relationship among sports group, sport-related concussion history and postural control was evaluated using mixed regression models while controlling for age and body mass index.

Results

Limited significant differences in balance metrics were found between the sports groups. A statistically significant (p < 0.001) interaction indicated a relationship between COP path length and sport-related concussion history in the most challenging balance condition, such that path length increased as the number of previous sport-related concussions increased.

Conclusion

There was some evidence for a relationship between sport-related concussion recurrence in sports players and postural stability in challenging balance conditions. There was no evidence of impaired balance ability in retired rugby players compared with non-contact sport athletes.

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Acknowledgements

Thanks are given to Dr Ken Quarrie (New Zealand Rugby) who initiated the NZ–RugbyHealth project, helped provided interpretation of results and provided editorial feedback on the manuscript and original technical report to World Rugby. We thank Dr Martin Raftery (World Rugby/IRB) for co-initiating the IRB/NZR/AUT RugbyHealth project and for providing feedback on the technical report that formed the basis of this manuscript. Thanks are given to Peter Griffiths and Serene Lorimer who provided research administration for the project, and to Dr Ian Murphy (New Zealand Rugby), Heath Mills (New Zealand Rugby Players Association) and Rob Nichol (New Zealand Cricket Players Association) who endorsed the project and helped with promotion of the study and recruitment of players. Thanks are given to Professor Stephen Marshall for statistical advice as a member of the IRB/NZR/AUT RugbyHealth project team and who co-authored the NZ–RugbyHealth report to World Rugby.

Author information

Authors and Affiliations

  1. Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand

    Patria A. Hume & Scott R. Brown

  2. Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand

    Patria A. Hume & Alice Theadom

  3. Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand

    Patria A. Hume

  4. Minderoo Tech & Policy Lab, The University of Western Australia, Perth, Australia

    Patria A. Hume

  5. Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand

    Gwyn N. Lewis, Usman Rashid & Denise Taylor

  6. Department of Kinesiology, Aquinas College, Grand Rapids, MI, USA

    Scott R. Brown

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  1. Patria A. Hume
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  4. Usman Rashid
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Corresponding author

Correspondence to Patria A. Hume.

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Data availability

As the study was funded by World Rugby and New Zealand Rugby, and the dataset is under embargo, the dataset and software analyses code for the research are not available unless a request is made to World Rugby.

Contributors statement

According to the definition given by the International Committee of Medical Journal Editors (ICMJE), the authors listed qualify for authorship based on making one or more of the substantial contributions to the intellectual content of the manuscript. Professor Patria Hume collaborated in designing the overarching IRB/NZR/AUT RugbyHealth project, was responsible for the original conception of the study, wrote the funding application, obtained ethical approval, helped recruit participants, analysed the initial data, helped interpret the results of the final COP data and co-authored the manuscript. Associate Professor Gwyn Lewis helped recruit participants, helped with data analysis and interpretation of the results, and co-authored the manuscript. Assistant Professor Scott Brown provided liaison for participants for the study, helped recruit participants, collected the balance data and co-authored the manuscript. Dr Usman Rashid re-analysed the balance data for COP metrics and co-authored the manuscript. Professor Alice Theadom helped recruit participants, helped with interpretation of the results and co-authored the manuscript. Professor Denise Taylor provided technical advice on the clinic testing protocol, developed the methods for the COP analysis of the data and co-authored the manuscript.

Authors' conflicts of interest

World Rugby and New Zealand Rugby provided funding for the project. All authors declare that they have no conflict of interest.

Ethics approval

The study was performed in accordance with the ethical standards of the Declaration of Helsinki given ethics approval was obtained from the Auckland University of Technology Ethics Committee (AUTEC #12/252). Participants gave informed consent after reading a participant information sheet about the project.

Funding

The study was funded by World Rugby (International Rugby Board) and New Zealand Rugby, and staff salaries provided in kind by the Sport Performance Research Institute New Zealand (SPRINZ), the National Institute for Stroke and Applied Neurosciences (NISAN) and the Health and Rehabilitation Research Institute (HRRI) of Auckland University of Technology.

Provenance and peer review

Not commissioned, externally peer reviewed.

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Hume, P.A., Lewis, G.N., Brown, S.R. et al. NZ–RugbyHealth Study: Current Postural Control Ability of Former Rugby Union and Non-contact Sport Players. Sports Med 53, 2257–2266 (2023). https://doi.org/10.1007/s40279-023-01864-7

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