Out today in @BJSM_BMJ #HotOffThePress

The relationships between rugby union, and health and well-being: a scoping review

A Thread - please feel free to share! #RugbyAndHealth

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Why do this study?

Majority of research has focused on link between rugby and injuries/concussion, with no 'big-picture' scientific overview of the potential relationships between rugby, and health and wellbeing

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We wanted to provide this overview so that players/parents etc could make evidence-informed decisions around participation, and to identify key areas where research is needed that would provide insights in the future

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Also, given that physical inactivity is one of the biggest health problems our our time, and sport is considered an ‘underused yet important’ contributor to #PhysicalActivity and health by the @WHO, we also wanted to know where rugby fit in...

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So we decided to undertake a scoping review - a type of study that is broad in nature and frequently used to 'map out' research areas. We followed gold-standard frameworks and published our protocol in @BMJOpenSEM as per best practice

https://bmjopensem.bmj.com/content/5/1/e000593

The #ScopingReview formed part of my PhD programme at @UoE_PAHRC with @s_fawkner & @narrowboat_paul as supervisors

We also had input from @EnglandRugby and @Scotlandteam via @drsimonkemp @drkeithstokes @docandrewmurray

Using a broad strategy, we found >6600 studies, of which 198 met the eligibility criteria. We found that studies fell into 5 themes:

Physical Activity; Physical Health; Mental Health; Wellbeing and Injuries (Systematic Reviews only) #RugbyAndHealth

In terms of physical activity, data suggests all forms of rugby union can provide health enhancing physical activity

Rugby may also play a role in providing muscle/bone health benefits, and in improving balance & coordination, though research needed here

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In terms of physical health:

1: CONTACT Rugby

Strong evidence that rates of OA & MSK issues
? function in some cognitive domains (big picture unclear overall)
Some studies show reduction in cardio-metabolic risk factors, but overall mixed picture and research needed

NON-CONTACT rugby:

Consistent evidence that in cardio-metabolic risk factors, across various populations

No evidence found in regard to cognitive or musculoskeletal health/function

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WHEELCHAIR RUGBY:

Participation linked to wide range of physical health benefits - rates of atherosclerosis, total body fat mass, cognitive & pulmonary function

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In terms of mental health:

Contact rugby: data only in elite populations where reporting of symptoms of common mental disorders (anxiety & depression) compared to general population (though looks similar to elite athletes in other sports)

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Non-contact rugby: no data
Wheelchair rugby: depressive symptomology & stress

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When it comes to general 'wellbeing' (looking at some wider psychosocial outcome measures):

Main take-home is that seemingly ++ benefits to wheelchair rugby (as seen in picture below)

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For contact rugby (no data in non-contact though potential crossover):

Rugby helps people stay mentally & physically active
Provides friendship & belonging
Players believe rugby provides them with positive benefits, such as fitness, confidence and strength

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In terms of injuries/concussions: main take-home (not sure this is news!) is that injury and concussion incidence rates for contact rugby union relative to other sports (especially at elite level)

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So, to tie it all together, what does this add?

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And, where do we go next? We're looking forward to continuing our work in this area, and have identified a few key research priorities that will inform our next steps

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But in the meantime, we hope our latest study helps the likes of players & parents etc with data to allow them to make informed decisions around participation.

Similarly, hopefully it provides NGBs with data to help inform policy & practice

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Thanks for reading, and please do share across your channels. We have created some resources that summarises the research, and will be sharing news & updates on our website https://rugbyhealthandwellbeing.com/  and on @RugbyAndHealth

If videos are more your things, then please consider sharing this animation kindly put together by @JenniferDunca10

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A huge thanks go to my @UoE_PAHRC supervisors @s_fawkner @narrowboat_paul for their expertise and for their patience, advice and support in general

To @docandrewmurray for inspiration, advocacy and for the lighting the PhD 'flame' with @KarimKhan_IMHA

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And finally to @drsimonkemp @drkeithstokes (and everyone else in the Medical Services dept @EnglandRugby) for all the support over the last 12-18 months, and for the chance to carry out this work at such a brilliant organisation

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Hope this thread has been useful - and happy to send over and pdf copies if you haven't got access too

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