Illness and infection in elite full-contact football-code sports: A systematic review

The effects of rule changes in football-code team sports: a systematic review

Rule changes within football-code team sports aim to improve performance, enhance player welfare, increase competitiveness, and provide player development opportunities. This manuscript aimed to review research investigating the effects of rule changes in football-code team sports. A systematic search of electronic databases (PubMed, ScienceDirect, CINAHL, MEDLINE, and SPORTDiscus) was performed to August 2023; keywords related to rule changes, football-code team sports, and activity type. Studies were excluded if they failed to investigate a football-code team sport, did not quantify the change of rule, or were review articles. Forty-six studies met the eligibility criteria. Four different football codes were reported: Australian rules football (n = 4), rugby league (n = 6), rugby union (n = 16), soccer (n = 20). The most common category was physical performance and match-play characteristics (n = 22). Evidence appears at a high risk of bias partly due to the quasi-experimental nature of included studies, which are inherently non-randomised, but also due to the lack of control for confounding factors within most studies included. Rule changes can result in unintended consequences to performance (e.g., longer breaks in play) and effect player behaviour (i.e., reduce tackler height in rugby) but might not achieve desired outcome (i.e., unchanged concussion incidence). Coaches and governing bodies should regularly and systematically investigate the effects of rule changes to understand their influence on performance and injury risk. It is imperative that future studies analysing rule changes within football codes account for confounding factors by implementing suitable study designs and statistical analysis techniques.

"Is the focus in professional rugby ever really on health?": A qualitative study on the uptake of illness prevention guidelines in rugby

Illness prevention is essential for athlete health management, but little is known about its uptake in sport. Prior to the pandemic, the International Olympic Committee (IOC) published a consensus statement recommending illness prevention guidelines are implemented in sports. Yet, little is known about guideline uptake. Therefore, this study aimed to explore the (1) illness experiences of rugby players and athlete support personnel and (2) barriers and enablers to illness prevention guideline uptake in rugby, using the lens of behaviour change theory. In a bid to inform and enhance athlete welfare, we sought to amplify the voices of participants through qualitative inquiry. Between August 2020 and May 2021, 16 semi-structured interviews were undertaken with players and athlete support personnel working across rugby. Analysis was conducted using Braun and Clarke's reflexive thematic analysis. Prior to COVID-19, participants deemed illness to be of little concern, with experience of illnesses and the global pandemic critical enablers to guideline uptake. The rugby environment was a barrier to illness prevention, particularly in women's and academy teams where resource deficiency was highlighted. 'Rugby identity' acted as both a barrier and enabler with participants' passion for rugby driving both guideline adherence and non-adherence. Tackling resource inequalities between men's and women's cohorts is critical to effectively implement guidelines. Coach and player education is essential, and emphasis must be placed on continuing preventative behaviours adopted due to COVID-19. Our findings offer new insight into illness prevention, moving away from prevailing quantitative research, and instead voicing players' experiences.

Contributors to negative biopsychosocial health or performance outcomes in rugby players (CoNBO): a systematic review and Delphi study protocol

The importance of contributors that can result in negative player outcomes in sport and the feasibility and barriers to modifying these to optimise player health and well-being have yet to be established. Within rugby codes (rugby league, rugby union and rugby sevens), within male and female cohorts across playing levels (full-time senior, part-time senior, age grade), this project aims to develop a consensus on contributors to negative biopsychosocial outcomes in rugby players (known as the CoNBO study) and establish stakeholder perceived importance of the identified contributors and barriers to their management. This project will consist of three parts; part 1: a systematic review, part 2: a three-round expert Delphi study and part 3: stakeholder rating of feasibility and barriers to management. Within part 1, systematic searches of electronic databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) will be performed. The systematic review protocol is registered with PROSPERO. Studies will be searched to identify physical, psychological and/or social factors resulting in negative player outcomes in rugby. Part 2 will consist of a three-round expert Delphi consensus study to establish additional physical, psychological and/or social factors that result in negative player outcomes in rugby and their importance. In part 3, stakeholders (eg, coaches, chief executive officers and players) will provide perceptions of the feasibility and barriers to modifying the identified factors within their setting. On completion, several manuscripts will be submitted for publication in peer-reviewed journals. The findings of this project have worldwide relevance for stakeholders in the rugby codes. PROSPERO registration number CRD42022346751.