Concussion and return-to-play : knowledge, roles and responsibilities in the Western Province club rugby role players

Van Vuuren, Johannes Odendaal (2020-03)

Thesis (MA)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: Rugby is a sport played globally and has a high risk of injury with concussion making up a fair proportion of these injuries. The knowledge of concussion has been said to influence the reporting of symptoms, and therefore, influencing the management and post-concussion return-to-play. A lack of knowledge has been reported in numerous role players, such as coaches, medical staff, administrative staff and not only in players. Education and translation of relevant information is needed to affect the attitude of role players for the correct implementation of return-to-play post-concussion. Within an amateur environment, medical assistance could be lacking, and therefore, the role of concussion management and post-concussion return-to-play should be shared among all role players. The first objective of the current study was to determine the knowledge and attitudes among amateur club rugby role players in the Western Province Rugby Union regarding concussion. The second objective was to investigate the post-concussion return-to-play implementation, roles and responsibilities among amateur club rugby role players. The thesis consists of two research articles. The first objective will be addressed in Article one, titled: ‘Concussion knowledge, risk- and precaution-taking attitude among amateur club rugby role players’. The results indicated that overall the participants scored 73% for concussion knowledge. The players scored the lowest (67%) in contrast to medical staff (79%) and referees (78%). Regarding the attitudes towards concussion, players (36%) demonstrated the highest risk-taking score in contrast to referees (90%), who demonstrated the greatest precaution taking score. The findings demonstrated the superior knowledge and attitude of referees and highlighted their importance in player’s safety. Article two, titled: Post-concussion return-to-play: Roles, responsibilities and implementation among amateur club rugby role players addresses the second objective of the study. The results indicated that coaches were perceived by players (74%) and other coaches (88%) to have knowledge of post-concussion RTP guidelines. Coaches were also deemed responsible by the majority of players (71%) and other coaches (80%) for monitoring training and matches for injuries. The correct order to the six-stage RTP protocol was successfully identified by less than half (40%) of medical staff and by only a third (37%) of the coaches, which warrants concern because this protocol was selected to be implemented in the event of a concussion. Coaches therefore, although being selected as responsible role player in RTP, revealed less than optimal post-concussion RTP protocol implementation. By investigating concussion and post-concussion RTP knowledge, roles, responsibilities within amateur club rugby, will help identify areas of concern. The areas of concern could include misconceptions in concussion knowledge or implementation of post-concussion RTP guidelines. A practical recommendation would be to have a pre-season education workshop strictly for concussion and post-concussion RTP for all role players within the club. This would encompass that concussion management systems are in place, medical staff qualifications are in order and that personnel can implement the post-concussion RTP protocol.

AFRIKAANSE OPSOMMING: Rugby is ‘n internasionale sport wat ‘n hoë risiko van beserings inhou, veral harsingskudding aangesien dit ‘n kontaksport is. Kennis van harsingskudding kan die aanmelding van simptome asook die bestuur daarvan en die terugkeer na spel affekteer. ‘n Tekort aan kennis is deur menige rolspelers onder andere afrigters, mediese en administratiewe personeel en nie slegs spelers nie, gerapporteer. Opleiding en die oordrag van relevante kennis word benodig om die terugkeer van spelers na harsingskudding te vergemaklik. Binne ‘n amateur omgewing kan mediese sorg ‘n tekortkoming wees en daarom moet harsingskudding deur alle rolspelers, voordat die speeler(s) na die spel kan terugkeer bestuur word. Die eerste doelwit van die studie was om te bepaal wat die kennis en ingesteldheid in Westelike Provinsie Rugby Unie klubs oor harsinskudding was. Die tweede doelwit was om na die na-konkussie terugkeer te bepaal wat die implementering, rolle en verantwoordelikhede in amateur rugby klub rugby rolspelers was. Die tesis is vervat in twee navorsingsartikels. Die eerste doelwit word aangespreek in Artikel een: ‘Harsingskudding kennis, risiko- en voorsorg-ingesteldheid van amateur klub rugby rolspelers’. Die resultate het getoon dat die deelmemers 73% verwerf het vir harsingskudding kennis, met spelers wat die laagste (67%) in kontras met mediese personeel (79%) en skeidsregters (78%) verwerf het. Aangaande die ingesteldheid tot harsingskudding het spelers (36%) die hoogste risiko totaal verwerf in kontras met skeidsregters (90%) wat die hoogste voorsorgmaatreel verwerf het. Die bevindinge demonstreer die uitmuntende kennis en ingesteldheid van skeidsregters en die belangrike rol wat hulle in speler veiligheid speel. Artikel twee is getiteld: ‘Harsingskudding terugkeer-na-spel implementasie, rolle en verantwoordelikhede in amateur klub rugby rolspelers’ en spreek die tweede doelwit aan. Die resultate het aangedui dat spelers (74%) en afrigters (88%) glo dat afrigters kennis behoort te dra van harsingskudding en die terugkeer na die spel. Afrigters was ook geag as verantwoordelik vir die monitering van oefening en wedstryde vir beserings deur beide spelers (71%) en afrigters (80%). Die korrekte ses-vlak terugkeer na spel protokol is slegs korrek geïdentifiseer deur (40%) van mediese personeel en slegs ‘n derde (37%) van die afrigters, wat kommerwekkend is aangesien dit die voorgestelde protokol is in die geval van harsingskudding. Alhoewel daar verwag is dat afrigters die meeste verantwoordelikheid moet dra met die terugkeer na die spel na harsingskudding, is hul implementering hiervan kommerwekkend. Deur ondersoek in te stel na harsingskudding en die terugkeer tot die spel, rolle en verantwoordelikhede in die amateur klub rugby kan help om areas van bekommernis te identifiseer. Dit kan tekortkominge in harsingskuding kennis en of die terugkeer na spel wees. ‘n Voorstel sal wees om ‘n voor-seisoen opleidingsessie vir harsingskudding en die terugkeer na die spel vir alle rolspelers binne die klub aan te bied. Dit behoort die korrekte harsingskudding bestuurssisteme, evaluasie van mediese kwalifikasies en dat rolspelers verstaan hoe om die terugkeer na die spel protokol te implementeer.

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