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Youth rugby is a popular sport in South Africa (SA) with a high injury incidence. The annual SA Rugby Youth Week tournaments attract the top age‐group players in the country providing a sample of players for reliable injury surveillance. The aim of the study was to analyze the changes in time‐loss injury rates at the SA Rugby Youth Week tournaments between 2011 and 2016, differences between age‐groups, and to investigate associated injury risk factors. All confirmed time‐loss injuries at the 4 age‐group tournaments (under‐13, under‐16, and 2 under‐18) from 2011 to 2016 were recorded. Injury incidence densities (IID) for years, tournaments, and injury risk factors were calculated and Poisson regression analyses were performed to determine differences. Time‐loss injuries (n = 494) were reported over 24 240 exposure hours, with an overall IID of 20.4 (18.6‐22.2) injuries per 1000 player hours. The year 2013 had a significantly lower IID compared to 2011. Injury risk decreased with increasing age; under‐13 and under‐16 had significantly higher IID compared to under‐18 Craven Week. Tackling was the phase of play at highest risk, with an IID of 7.4 (6.3‐8.5) injuries per 1000 player hours. Central/peripheral nervous system (CNS/PNS) and, therefore, the head/neck were the most commonly occurring injuries/location injured. In conclusion, within the SA Rugby tournament structure, the older players had a decreased rate of injury. The tackle event was still the phase of play with the highest injury incidence regardless of age. This increase in incidence is largely due to an increase in CNS/PNS injuries. [ABSTRACT FROM AUTHOR]

Rugby Union ('rugby') participants have a higher than average risk of injury compared with participants of other popular team sports. Bok Smart, a nationwide injury prevention program was launched in South Africa in mid-2009, with the goal of reducing catastrophic head/neck (serious) injuries in players. The program provides injury prevention information to coaches and referees. This study investigated if Bok Smart has been associated with a reduction in these injuries. The Bok Smart program collected data on all South African rugby-related serious injuries since 2008. Using a Poisson regression, injury numbers were compared pre- Bok Smart (2008-2009) to the years post-implementation (2010-2013). Player numbers were assumed to be constant throughout this evaluation: junior = 529 483; senior = 121 663. In junior players, the 'post- Bok Smart' period had 2.5 less annual serious injuries than 'pre- Bok Smart' (incidence rate ratio: 0.6, 95% confidence interval: 0.5-0.7, P < 0.000). In contrast, there was no significant difference in these periods in seniors. The absence of effect in seniors may be a result of fewer players or of differences in effectiveness of Bok Smart in this group - future studies should investigate these questions. [ABSTRACT FROM AUTHOR]

Background. The emergence of the pedometer as a useful motivational aid for increasing physical activity (PA) has supported its use in PA interventions. Objectives. To examine the feasibility of a 10-week pedometer-based intervention complemented by regular motivational messages, to increase ambulatory PA; and to determine the minimum sample size required for a randomised, controlled trial (RCT). Methods. Participants, sourced by convenience sampling of employees from an academic institution, were randomly assigned to either an intervention group (IG) (n=11) or control group (CG) (n=11), following baseline health measurements and blinded pedometer wear (week 1). Participants in the IG subsequently wore an unblinded pedometer (10 weeks) to self-monitor daily steps. Individualised messages using pedometer data (IG) and general motivational messages (IG and CG) were provided bi-weekly. Blinded pedometer wear (IG and CG) and a feedback questionnaire (IG) were completed at week 12. Pedometer data were compared between the IG and CG at week 12. Results. Participants' perceptions of the intervention supported the benefit of the pedometer as a useful motivational aid and a reminder to increase steps per day. Occupational sitting time and inability to incorporate PA into daily routine emerged as the main barrier to adherence. Steps per day increased more in the IG (mean ± standard deviation (SD) 996±1 748) than in the CG (mean±SD 97±750). Modest improvements were noted in all clinical measures (IG). Conclusion. Based on the improvement of 1 000 steps/day (IG), a minimum of 85 participants in the IG and CG, respectively, is required for a future RCT (80% power; P<0.05). We recommend a minimum of 150 participants in each group to account for loss to follow-up and to allow for subgroup analyses. [ABSTRACT FROM AUTHOR]

Background: Rugby carries a risk for serious injuries, including acute spinal cord injuries. The lifetime health consequences of these injuries may be far-reaching., Purpose: In this study, we aimed to describe barriers and facilitators to healthcare and rehabilitation, in individuals with rugby-related spinal cord injuries in South Africa., Methods: This study adopted a pragmatic qualitative approach. Stratified purposive sampling was used to select interviews from players from a variety of socio-economic status and geographical areas for inclusion in this study. The final sample consisted of thirty-one (n = 31) participants. Thematic analysis was used to analyze the data., Results: Participants described long-term, accessible, affordable, quality healthcare and rehabilitation as important contributors to their quality of life. Even though public healthcare is accessible from a cost point of view, quality of care, availability of rehabilitation services and factors such as affordability and availability of adequate transport remain a barrier for lower socio-economic groups., Conclusion: This population was unique, as the support from a dedicated organization enabled participants to overcome some barriers, highlighting the challenges of the healthcare system in maintaining the health of people with spinal cord injuries. Every effort should be made to create equitable access to healthcare and rehabilitation for persons with spinal cord injuries in South Africa.

Purpose: This cross-sectional study aimed to compare the association between self-reported sleep duration and cardiometabolic risk among men and women corporate executives and investigate potential lifestyle, work- and stress-related mediators thereof., Methods: Self-reported sleep duration and lifestyle, occupational, psychological and measured anthropometrical, blood pressure (BP) and blood marker variables were obtained from health risk assessment data of 3583 corporate executives. Sex-stratified regression analyses investigated the relationships between occupational and psychological variables with self-reported sleep duration, and sleep duration with individual cardiometabolic risk factors. Mediation analyses investigated the effects of work, psychological and lifestyle factors on the relationships between self-reported sleep duration and cardiometabolic risk factors, as well as a continuous cardiometabolic risk score calculated from the sum of sex-stratified z-standardized scores of negative fasting serum HDL, and positive plasma Glu, serum TG, body mass index (BMI), waist circumference, systolic and diastolic BP., Results: Longer work hours and work commute time, depression, anxiety and stress were associated with shorter sleep duration in both men and women (all p < 0.05). Shorter sleep duration was associated with higher BMI, larger waist circumference and greater cardiometabolic risk scores in both men and women (all p < 0.05), higher diastolic BP in men (p < 0.05) and lower HDL cholesterol in women (p < 0.05). Physical activity, working hours and stress significantly mediated the relationships between self-reported sleep duration and BMI, waist circumference, diastolic BP and cardiometabolic risk score in men only., Conclusion: In these corporate executives, shorter self-reported sleep duration is associated with poorer psychological, occupational and cardiometabolic risk outcomes in both men and women. Given that physical activity, working hours and stress mediate this association among the men, the case for sleep health interventions in workplace health programmes is warranted., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.

Objectives: Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury., Design: Prospective cohort METHODS: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences., Results: IID was 28.8 (18.9-38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6-414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2-17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8-18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5-196.6) days lost per 1000 player hours)., Conclusions: The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objectives: Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework., Design: Descriptive cross-sectional study., Setting: Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database., Participants: Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study., Main Outcome Measure: The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses., Results: The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001)., Conclusions: On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries., Design: This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs., Methods: Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities., Results: Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302)., Conclusions: Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background/aim: Participants of rugby union ('rugby') have an above-average risk of injury compared with other popular sports. Thus, BokSmart, a nationwide injury prevention programme for rugby, was introduced in South Africa in 2009. Improvements in injury-preventing behaviour of players are critical to the success of an intervention. The aim of this study was to assess whether BokSmart has been associated with improvements in rugby player behaviour., Methods: An anonymous knowledge, attitude and self-reported behaviour questionnaire was completed by junior (under-18) and senior (adult) tournament players who attended merit-based tournaments (2008-2012). The questionnaire was completed by 2279 junior players (99% of total estimated population) from 111 teams and 1642 senior players (96% of population) from 81 teams. A generalised linear model assessed behavioural changes over this time period., Results: Nine (50%) of the behaviours improved significantly (p<0.005) between 2008 and 2012 and the remaining behaviours remained unchanged. Improved behaviours included the targeted, catastrophic injury-preventing behaviours of the intervention: practising of tackling (adjusted overall improvement in odds: 56%) and scrummaging, in forwards only (58%), techniques. Other behaviours that improved significantly were postinjury compression and elevation as well as alcohol avoidance, mouthguard use (training and matches) and cooling down (training and matches). Practising of safe rucking techniques; warming up before training/matches; ice use; heat, massage and alcohol avoidance postinjury; and preseason and off-season conditioning remained unchanged., Conclusions: BokSmart is associated with improvements in targeted injury-preventing behaviours in players. Future research should ascertain whether self-reported behaviours reflect actual behaviour and whether the observed improvements translate into changes in injury rates., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: Physical activity (PA) has been identified as a central component in the promotion of health. PA programs can provide a low cost intervention opportunity, encouraging PA behavioral change while worksites have been shown to be an appropriate setting for implementing such health promotion programs. Along with these trends, there has been an emergence of the use of pedometers as a self-monitoring and motivational aid for PA.This study determines the effectiveness of a worksite health promotion program comprising of a 10-week, pedometer-based intervention ("Steps that Count!"), and individualized email-based feedback to effect PA behavioral change., Methods: The study is a randomized controlled trial in a worksite setting, using pedometers and individualized email-based feedback to increase steps per day (steps/d). Participant selection will be based on attendance at a corporate wellness event and information obtained, following the completion of a Health Risk Appraisal (HRA), in keeping with inclusion criteria for the study. All participants will, at week 1 (pre-intervention), be provided with a blinded pedometer to assess baseline levels of PA. Participants will be provided with feedback on pedometer data and identify strategies to improve daily PA towards current PA recommendations. Participants will thereafter be randomly assigned to the intervention group (INT) or control group (CTL). The INT will subsequently wear an un-blinded pedometer for 10 consecutive weeks.Individualized feedback messages based on average steps per day, derived from pedometer data (INT) and general supportive/motivational messages (INT+CTL), will be provided via bi-weekly e-mails; blinded pedometer-wear will be conducted at week 12 (post-intervention: INT+CTL)., Discussion: The purpose of this paper is to outline the rationale behind, and the development of, an intervention aimed at improving ambulatory PA through pedometer use, combined with regular, individualized, email-based feedback. Pedometer-measured PA and individualized feedback may be a practical and easily applied intervention.