Edinburgh Napier University

  Concussion is a traumatic brain injury which is common in rugby union across the world, yet knowledge of concussion epidemiology in professional Scottish rugby union was previously limited. This thesis therefore investigated epidemiology, aetiology and a potential preventative measure of concussion in professional rugby union in Scotland by following van Mechelen’s “Sequence of Prevention of Sports Injuries” model (van Mechelen et al, 1992) and other injury investigation methodologies (Fuller & Drawer, 2004; Meeuwisse et al, 2007). Following research recommendations from the rugby research consensus (Fuller et al, 2007d), medically collected injury data and GPS match and training exposure demonstrated concussion was the primary match injury in four of the five professional cohorts in Scotland during the 2017/18 and 2018/19 seasons. Concussion incidences were 22.5-37.3/1000 player match hours. Regression analysis of intrinsic concussion history and extrinsic contact event specific risk factors for concussion outcome found severity of most-recent concussion, high impact forces and being struck on the head and shoulder to statistically increase probability of concussion in tackle situations. The results imply that rule changes to the game of rugby and implementation of individualised concussion recovery protocols may reduce probability of concussion outcomes. A novel neck training programme to improve neck function and reduce concussion incidence was found to result in statistical improvements in neck strength and endurance for the intervention group compared with the control. Match concussion incidences were 7.7 (intervention) and 18.4/1000 player match hours (control). As a result, further work to implement this programme on a wider scale throughout Scottish Rugby was recommended. Concussion can cause various short- and long-term implications for individual players and professional rugby union squads. This thesis suggests possible future areas of research that are hoped to be developed to attempt to reduce concussion incidence in both Scottish and world-wide professional rugby union.