Cognitive function among first division KwaZulu-Natal Rugby Union players and its associations with duration of exposure to the sport and a history of concussion

Abstract

Background Rugby union (‘rugby’) is a popular sport that is also associated with a higher-thanaverage risk of concussion injury compared with other popular team sports. A recent study in New Zealand found that a history of rugby participation or concussions were associated with neurocognitive deficits, as measured by CNS Vital Signs (CNSVS) test battery. Although it is a vastly different context, rugby is just as popular in South Africa as in New Zealand. Despite this, no study to date has quantified the effects of rugby exposure and concussion history as measured by CNSVS. Aim The aim of the study was to determine the association between cognitive function and rugby exposure and/or concussion history among adult first division rugby players in South Africa. Research methodology The research conducted was a cross-sectional survey which targeted first division rugby players in KwaZulu-Natal. The research tools used were the CNSVS test battery and the General Health Rugby (GHR) questionnaire which were used in a similar study in New Zealand. Results and discussion This study revealed a weak Pearson coefficient -0.24 (p = 0.05) between the number of years of rugby playing experience and neurocognitive index (NCI) score, which indicated that every additional year of rugby played resulted in a minor decrease in the NCI score of the respondents. However, multiple regression analyses revealed that the association between rugby playing experience and NCI score was attenuated (p = 0.41). Despite the multiple regression association not being significant (p = 0.53), this study reported medium to large effect size inverse associations between the number of concussions sustained by the players and their NCI domain scores. Conclusion and recommendations Rugby is a physically demanding team sport played in South Africa as well as across the globe, therefore the need for research pertaining to neurological health in rugby is necessary. This study indicated a weak negative association between the number of years of rugby playing experience and the respondents’ NCI scores. Furthermore, this study reported a medium to large effect size inverse association between the number of concussions sustained by the players and their NCI domain scores, and as such warrants further exploration in more prospective studies. There is a need for additional research with regards to neurological health in rugby players, taking into account concussive and sub-concussive exposure.