Effectiveness of the <i>Activate</i> injury prevention exercise programme to prevent injury in schoolboy rugby union.

Abstract

The efficacious <i>Activate</i> injury prevention exercise programme has been shown to prevent injuries in English schoolboy rugby union. There is now a need to assess the implementation and effectiveness of <i>Activate</i> in the applie setting. This quasi-experimental study used a 24-hour time-loss injury definition to calculate incidence (/1000 hours) and burden (days lost/1000 hours) for individuals whose teams adopted <i>Activate</i> (used <i>Activate</i> during season) versus non-adopters. The dose-response relationship of varying levels of <i>Activate</i> adherence (median <i>Activate</i> sessions per week) was also assessed. Player-level rugby exposure, sessional <i>Activate</i> adoption and injury reports were recorded by school gatekeepers. Rate ratios (RR), adjusted by cluster (team), were calculated using backwards stepwise Poisson regression to compare rates between adoption and adherence groups. Individuals in teams adopting <i>Activate</i> had a 23% lower match injury incidence (RR 0.77, 95% CI 0.55 to 1.07), 59% lower training injury incidence (RR 0.41, 95% CI 0.17 to 0.97) and 26% lower match injury burden (95% CI 0.46 to 1.20) than individuals on non-adopting teams. Individuals with high <i>Activate</i> adherence (≥3 sessions per week) had a 67% lower training injury incidence (RR 0.33, 95% CI 0.12 to 0.91) and a 32% lower match injury incidence (RR 0.68, 95% CI 0.50 to 0.92) than individuals with low adherence (<1 session per week). While 65% of teams adopted <i>Activate</i> during the season, only one team used <i>Activate</i> three times per week, using whole phases and programme progressions. <i>Activate</i> is effective at preventing injury in English schoolboy rugby. Attention should focus on factors influencing programme uptake and implementation, ensuring <i>Activate</i> can have maximal benefit.