Rugby Fans in Training New Zealand (RUFIT NZ): a randomized controlled trial to assess the effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs.

BACKGROUND: A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Maori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. AIMS: To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. METHODS: We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30-65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. RESULTS: Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. CONCLUSION: RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245-0645.

Home-based high-intensity interval training can improve physical performance in young female athletes during a quarantine

Abstract Aim: To verify the effects of a 2-week of high-intensity interval training (HIIT) on physical performance in young female athletes. Methods: female rugby players (n = 13; 15.92 ± 0.76 years old) participated in an 8-session of HIIT supervised through online video calls for two weeks. They were evaluated pre- and post-HIIT for 3-min of burpees, 1-min of sit-ups, maximum push-ups, and 1-min of squats. Perceptions related to training protocols were collected through the Physical Activity Enjoyment Scale (PACES) post-intervention. Results: Significant improvements in burpees (pre:54.15 ± 18.03 and after: 63.15 ± 15.18), sit-ups (pre:24.38 ± 13.38 and after: 31.15 ± 13.15), push-ups (pre: 9.46 ± 6.59 and after: 13.85 ± 7.33) and squats (pre: 48.00 ± 8.37 and after: 54.85 ± 8.79) were observed. PACES revealed positive perceptions related to the enjoyment of participating in this HIIT. Conclusion: Virtually supervised HIIT improved physical performance in young female athletes during the COVID-19 pandemic, and maybe an efficient strategy for the quarantine period.

Tackle and ball carrier demands of rugby league: a seven-year league-wide study including over 1,000,000 tackle events.

OBJECTIVES: Describe the highest frequency and variability for tackle events in rugby league. Investigate seasonal differences in total tackle events per match over a seven-year period. DESIGN: Retrospective observational. METHODS: Tackle events (i.e., ball carrier events [attacker] and tackler involvements [defender]) from 864 male professional rugby league players competing in 1176 Super League matches from 2014 to 2020 were included. A series of linear mixed effect models were used to determine the frequency and variability during peak 1-, 3-, 5-, 10-, 20-, 40-min and whole-match tackle events per player per match at a positional group level. Differences between seasons for the total number of tackle events per match were compared using a one-way analysis of variance and with Tukey's honestly significant difference test. RESULTS: Tackle events were greatest for Props (51.5 [47.7-55.4] per match). Within-players, between-matches, and between-seasons variability was <10 % for tackle events. There were significantly less tackle events and tackler involvements per match in 2014 and a significantly more tackle events per match in season 2020b when compared with all other seasons. CONCLUSIONS: Large between-position variability in peak tackle events, ball carrier events, and tackler involvements would suggest that coaches should separate players into positional groups and prescribe training accordingly. Total number of tackle events, ball carrier events, and tackler involvements were significantly greater in season 2020b when compared to season 2014 to 2019 (inclusive) which may be a consequence of rule changes introduced to the sport.

The implementation of a neck strengthening exercise program in elite rugby union: A team case study over one season.

OBJECTIVES: To investigate the effect of a neck strengthening program on maximal isometric neck strength and incidence of head and neck injuries including concussion, and to evaluate the acceptability and feasibility of the program within one professional men's rugby union team over one season. DESIGN: Pre- and post-intervention study. METHODS: A phased neck strengthening program was implemented in one rugby union team (n = 26 Forward Group; n = 13 Back Group) throughout the 2020 Super Rugby season, with maximal isometric neck strength measured at each training phase. Strength changes were analysed using one-way, repeated measures analysis of variance and paired samples t-test. Injury data from 2019 to 2020 were compared using incidence rate ratios (IRR). Player and staff surveys, reported as percentage of agreement, assessed program acceptability and feasibility. RESULTS: Forward Group's neck flexors (p < 0.001), left-lateral flexors (p = 0.04) and flexor/extensor ratio (p < 0.001) and Back Group's neck flexors (p = 0.01) significantly improved across the season, with uncertain evidence to support the reduction of head and neck injuries (IRR:0.86 (0.23-2.56) and concussion (IRR:0.63 (0.06-3.34) between seasons. Survey responses revealed high percentages of agreement for the program's acceptability and feasibility. CONCLUSIONS: Targeted sport-specific neck exercises have the potential to increase the maximal isometric neck strength of professional rugby players and may assist in reducing head and neck injuries including concussion.

The incidence and transmission of SARS-CoV-2 infection in South African professional rugby players - AWARE II.

OBJECTIVES: To describe the incidence and transmission of SARS-CoV-2 infections in South African professional rugby union players in different phases of return-to-competition during a pandemic. DESIGN: Prospective cohort study. METHODS: Players reported their history of SARS-CoV-2 infection before/during a national competition, using an online questionnaire (physician verified). Three periods of return to training/competition after a nation-wide complete lockdown during a pandemic were studied: 1) non-contact training, 2) contact training, 3) competition. The total period was 184 days (20/07/2020-20/01/2021) including 45 matches. Outcomes were: 1) incidence of SARS-CoV-2 infection (I: per 1000 player days; 95%CI) in each period (calculated using a Poisson distribution), 2) player symptoms, 3) median days to return-to-training following SARS-CoV-2 infection, 4) method of transmission, and 5) percentage matches cancelled due to SARS-CoV-2 infections. RESULTS: 185 players had 42 physician verified positive SARS-CoV-2 infections (I = 1.23; 95%CI: 0.86-1.61). Incidences during the three periods were: non-contact training = 0, contact training (I = 1.04; 0.36-1.71; mostly forwards), and competition (I = 1.54; 1.00-2.10). 83 % of the infected players were symptomatic and 52 % of the 42 positive players had systemic symptoms. Median return-to-training was 14 days. 22 (52 %) SARS-CoV-2 infections were rugby-related: 13 off-field (31 %), 9 on-field (21 %). 11 % of matches were cancelled due to SARS-CoV-2 infections. CONCLUSIONS: As contact in rugby was introduced back into the game following lockdowns there was an increasing incidence of SARS-CoV-2 infection. On-field rugby activities were responsible for 21 % of SARS-CoV-2 infections and 11 % of matches had to be cancelled, indicating the need for risk mitigation strategies.

Physical Fitness and Inflammatory Response to the Training Load of Wheelchair Rugby Players.

The aim of the study was the evaluation of the hormonal response of wheelchair rugby participants under the half-year training cycle. The study sample included 11 members of the Polish national wheelchair rugby team with spinal cord injury at the cervical level, ranging in age from 21 to 41 years, body weight (72.2 ± 11.53 kg), and body height (182.3 ± 6.11 cm). The disabled individuals with spinal cord injury subjected to the study constitute a homogeneous group in terms of age, body height, weight, and injury level. The study was carried out at the beginning and at the end of a 6-month training period. In the first and second examination, measurements of the peak oxygen uptake (peakVO2) and blood biochemical analysis were performed (Lactate dehydrogenase (LDH) activity and concentration of creatinine (Cr), total testosterone (TT), free testosterone (FT), and cortisol (C)). A significant change was observed in the concentration of C in the Wheelchair Rugby players' blood between two research periods (p < 0.05 (ES:0.76)) and a correlation between the post-training change in FT/C concentration and the change in Cr concentration (r = -0.6014, p < 0.05). The 6-month training period did not result in overloads within the group of players. However, due to the significant loss of the capacity of the spinal cord injury (SCI) and the possibility of a life-threatening trend, the anabolic/catabolic status of the players should be monitored using blood biochemical indices.

Anxiety and Depressive Symptoms in the New Life With COVID-19: A Comparative Cross-Sectional Study in Japan Rugby Top League Players.

Objectives: The primary objective is to compare the prevalence of mental health problems, including psychological distress, anxiety and depressive symptoms in Japan Rugby Top League players in the new life with COVID-19 with those evaluated before COVID-19. Methods: An observational comparative web-based cross-sectional study was employed for Japan Rugby Top League players. We compared the data from 220 Japanese and 7 foreign players during the new life with COVID-19 with the data from before COVID-19, which was obtained from 233 Japanese and 18 foreign players. We measured anxiety and depression symptoms with the validated Kessler-6, which has been widely used in clinical and research settings among different populations. To investigate the distribution of K6 score and whether there are discrete clusters or not, we conducted the two-step cluster analysis. Results: In the new life with COVID-19, 15.0% of players reported mild symptoms, which was significantly lower than the 32.3% of players before COVID-19. The prevalence of moderate and severe symptoms was 6.7 and 3.5%, respectively, in the group during the new life with the COVID-19, and 4.8 and 5.2% in the pre-COVID-19 group, with no significant difference. A two-step cluster analysis supported the existence of these two qualitatively different clusters in both groups. Conclusions: With the spread of new lifestyles related to COVID-19, some rugby players may have improved mental health status due to changes in their daily living environment. Such environmental adjustments alone may not have been sufficient to change the mental health status of others. Rugby players or their teams may require mental health professionals and systems that ensure rest, adjust the environment, and sustainably provide more professional care.

Wearables in rugby union: A protocol for multimodal digital sports-related concussion assessment.

BACKGROUND: Pragmatic challenges remain in the monitoring and return to play (RTP) decisions following suspected Sports Related Concussion (SRC). Reliance on traditional approaches (pen and paper) means players readiness for RTP is often based on self-reported symptom recognition as a marker for full physiological recovery. Non-digital approaches also limit opportunity for robust data analysis which may hinder understanding of the interconnected nature and relationships in deficit recovery. Digital approaches may provide more objectivity to measure and monitor impairments in SRC. Crucially, there is dearth of protocols for SRC assessment and digital devices have yet to be tested concurrently (multimodal) in SRC rugby union assessment. Here we propose a multimodal protocol for digital assessment in SRC, which could be used to enhance traditional sports concussion assessment approaches. METHODS: We aim to use a repeated measures observational study utilising a battery of multimodal assessment tools (symptom, cognitive, visual, motor). We aim to recruit 200 rugby players (male n≈100 and female n≈100) from University Rugby Union teams and local amateur rugby clubs in the North East of England. The multimodal battery assessment used in this study will compare metrics between digital methods and against traditional assessment. CONCLUSION: This paper outlines a protocol for a multimodal approach for the use of digital technologies to augment traditional approaches to SRC, which may better inform RTP in rugby union. Findings may shed light on new ways of working with digital tools in SRC. Multimodal approaches may enhance understanding of the interconnected nature of impairments and provide insightful, more objective assessment and RTP in SRC. CLINICAL TRIAL REGISTRATION: NCT04938570. https://clinicaltrials.gov/ct2/results?cond=NCT04938570&term=&cntry=&state=&city=&dist=.

Implementation study of SARS-CoV-2 antigen lateral flow tests in men's professional (Premiership) rugby union sports squads in England during the COVID-19 pandemic.

This study evaluated the validity and utility of antigen-detection rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2 in elite sports. The data on utility, ease of use and application for Ag-RDTs as a new testing format were positive from players and staff. This evaluation was limited by the low prevalence of SARS-CoV-2 circulating within the three squads. This study highlights the need for continued service evaluations for SARS-CoV-2 Ag-RDTs in elite sport settings.

A Machine Learning Approach to Analyze Home Advantage during COVID-19 Pandemic Period with Regards to Margin of Victory and to Different Tournaments in Professional Rugby Union Competitions.

Home advantage (HA) is the tendency for sporting teams to perform better at their home ground than away from home, it is also influenced by the crowd support, and its existence has been well established in a wide range of team sports including rugby union. Among all the HA determinants, the positive contribute of the crowd support on the game outcome can be analyzed in the unique pandemic situation of COVID-19. Therefore, the aim of the present study was to analyze the HA of professional high-level rugby club competition from a complex dynamical system perspective before and during the COVID-19 pandemic. HA was analyzed in northern and southern hemisphere rugby tournaments with (2013-2019) and without (2020/21) crowd support by the means of the exhaustive chi-square automatic interaction detection (CHAID) decision trees (DT). HA was mitigated by the crowd absence especially in closed games, although differences between tournaments emerged. Both for northern and southern hemisphere, the effect of playing without the crowd support had a negative impact on the home team advantage. These findings evidenced that in ghost games, where differences in the final score were less than a converted try (7 points), HA has disappeared.

Longitudinal changes in Super League match locomotor and event characteristics: A league-wide investigation over three seasons in rugby league.

The 2019 and 2020 Super League (SL) seasons included several competition rule changes. This study aimed to quantify the difference between the 2018, 2019 and 2020 SL seasons for duration, locomotor and event characteristics of matches. Microtechnology and match event data were analysed from 11 SL teams, comprising 124 players, from 416 competitive matches across a three-year data collection period. Due to an enforced suspension of league competition as a consequence of COVID-19 restrictions, and subsequent rule changes upon return to play, season 2020 was divided into season 2020a (i.e. Pre-COVID suspension) and season 2020b (i.e. Post-COVID suspension). Duration, locomotor variables, and match events were analysed per whole-match and ball-in-play (BIP) periods with differences between seasons determined using mixed-effects models. There were significant (ρ ≤ 0.05) reductions in whole-match and BIP durations for adjustables and backs in 2019 when compared to 2018; albeit the magnitude of reduction was less during BIP analyses. Despite reduced duration, adjustables reported an increased average speed suggesting reduced recovery time between bouts. Both forwards and adjustables also experienced an increase in missed tackles between 2018 and 2019 seasons. When comparing 2019 to 2020a, adjustables and backs increased their average speed and distance whilst all positional groups increased average acceleration both for whole-match and BIP analyses. When comparing 2020a to 2020b, all positional groups experienced reduced average speed and average acceleration for both whole-match and BIP analyses. Forwards experienced an increased number of tackles and carries, adjustables experienced an increased number of carries, and backs experienced an increased number of missed tackles when comparing these variables between season 2020a and 2020b. Rule changes have a greater effect on whole-match duration and locomotor characteristics than those reported during BIP periods which suggests the implemented rule changes have removed stagnant time from matches. Amendments to tackle related rules within matches (e.g., introduction of the 'six-again' rule) increases the number of collision related events such as carries and tackles.

Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills.

The COVID-19 pandemic created stressors that raised the likelihood of elite athletes experiencing mental health problems. Understanding how individual traits promote resilience is key to offering treatments specific to this population. This prospective study explores the relationship between mindfulness skills, resilience, and athletic identity on anxiety and depression. The initial assessment was during the first UK lockdown April-May 2020 (T1), and the second during the return to competition July-August 2020 (T2). The sample was 160 elite rugby players. Measures included: Personal Health Questionnaire-9, General Anxiety Disorder-7, Cognitive Affective Mindfulness Scale, Connor-Davidson Resilience Scale, and Athletic Identity Measurement. The prevalence of anxiety and depression was profiled with descriptive statistics, and relationships between variables with bi-variate correlations and forward stepwise regression modelling. Depression decreased significantly between lock down (T1) and return to competition (T2) (MT1 = 4.20, MT2 = 3.24, p < 0.01), with no significant change in anxiety. Significant correlations were found between mindfulness, resilience, and anxiety and depression (≤0.001). Regression showed that mindfulness (T1) predicted lower anxiety and depression during the return to competition (T2) after controlling for baseline mental health symptoms. Returning to competition after lockdown was associated with a reduction in depression but not anxiety. Mindfulness skills potentially confer protection against anxiety and depression.

Evaluation of the impact of the COVID-19 lockdown on the quality of life of patients monitored for cancer who practice an adapted physical activity: rugby for health.

PURPOSE: The benefits of regular physical exercise on the tolerability of cancer treatments, quality of life and survival rates post-diagnosis have been demonstrated but all supervised physical activities have been interrupted due to the global health crisis and the need for lockdown to halt the spread of SARS-CoV-2. To reintroduce activities post-lockdown, we wanted to assess the impact of the COVID-19 lockdown on the quality of life and the psychological status of patients who practice an adapted physical activity such as rugby for health. METHODS: The evaluation was conducted in two phases: an initial self-questionnaire comprised of 42 questions sent to all participants to assess the impact of lockdown and a second assessment phase in the presence of the participants. We assessed anthropometric data, functional fitness parameters, quality of life and the psychosocial status of the subjects. The data were compared to pre-lockdown data as part of a standardised follow-up procedure for patients enrolled in the programme. RESULTS: 105/120 (87.5%) individuals responded to the rapid post-lockdown survey analysis. In 20% of the cases, the patients reported anxiety, pain, a decline in fitness and a significant impact on the tolerability of cancer treatments. Twenty-seven patients agreed to participate in the individual analysis. Following lockdown, there was a significant decrease in the intensity of physical activity (p = 8.223e-05). No post-lockdown changes were noted in the assessments that focus on the quality of life and the level of psychological distress. Conversely, there was a significant correlation between the total of high energy expended during lockdown and the quality of life (p = 0.03; rho = 0.2248) and the level of psychological distress post-lockdown (p = 0.05; rho = - 0.3772). CONCLUSION: Lockdown and reduced physical activity, particularly leisure activities, did not impact the overall health of the patients. However, there was a significant correlation with the level of physical activity since the higher the level of physical activity, the better the quality of life and the lower the level of psychological distress.