{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:08:52Z","timestamp":1778742532336,"version":"3.51.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"World Rugby"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sports Med"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>The aim of this study was to compare the incidence, severity, and burden of injury in starting and replacement players from professional men\u2019s teams of five rugby unions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Match injuries of greater than 24\u00a0h time-loss (including data on the severity, match quarter, event, body region) and player minutes of match exposure data were collated for all starting and replacement players in the men\u2019s English Premiership, Welsh Pro14 (both 2016\/17\u20132018\/19 seasons), and Australian, New Zealand, and South African Super Rugby (all 2016\u20132018 seasons) teams. Injury incidences and mean injury burden (incidence\u2009\u00d7\u2009days missed) were calculated, and rate ratios (RRs) (95% confidence intervals [CIs]) were used to compare injury incidence and burden between starting (reference group) and replacement players.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall injury incidence was not different between starters and replacements for all injuries (RR\u2009=\u20090.98, 95% CI 0.88\u20131.10), nor for concussions (RR\u2009=\u20090.85; 95% CI 0.66\u20131.11). Mean injury burden was higher for replacement players (RR\u2009=\u20091.31, 95% CI 1.17\u20131.46). Replacement injury incidence was lower than the starters in the third (RR\u2009=\u20090.68, 95% CI 0.51\u20130.92) and fourth (RR\u2009=\u20090.78, 95% CI 0.67\u20130.92) match quarters. Injury incidence was not different between starters and replacements for any match event or body region, but compared with starters, replacements\u2019 injury burden was higher in lower limbs (RR\u2009=\u20091.24, 95% CI 1.05\u20131.46) and in the tackled player (RR\u2009=\u20091.30, 95% CI 1.01\u20131.66).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study demonstrated a lower injury incidence in replacement players compared with starters in the second half of matches, with a higher injury burden for replacement players due to higher mean injury severity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s40279-024-02014-3","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T16:02:11Z","timestamp":1712937731000},"page":"2157-2167","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Injury in Starting and Replacement Players from Five Professional Men\u2019s Rugby Unions"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2402-0749","authenticated-orcid":false,"given":"Simon P.","family":"Roberts","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith A.","family":"Stokes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen W.","family":"West","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Cross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel S.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte Leah","family":"Bitchell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhat","family":"Mathema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Quarrie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren","family":"McDonald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Fortington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Rubio del Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clint","family":"Readhead","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Sewry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9anna","family":"Falvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"2014_CR1","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.jsams.2012.08.005","volume":"16","author":"KL Quarrie","year":"2013","unstructured":"Quarrie KL, Hopkins WG, Anthony MJ, et al. 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KAS received funding for this work from World Rugby, the Rugby Football Union, and Premiership Rugby and has previously received funding for other projects from the Rugby Players Association and the RFU Injured Players Foundation. KQ is employed by New Zealand Rugby and is on the World Rugby Scientific Committee. He has travelled to World Rugby meetings and been provided with accommodation at their expense for meetings and conferences. WM is contracted by Rugby Australia as Chief Medical Officer. LF is on the editorial board at Sports Medicine. ERdC is supported by a PhD scholarship at ECU (awarded to LF by Rugby Australia). CR is employed by the South Africa Rugby Union. ISM receives funding from the Welsh Rugby Union. PM is employed by the Welsh Rugby union. CLB was funded by the Knowledge Economy Skills Scholarships (KESS 2), which is a pan-Wales higher level skills initiative led by Bangor University on behalf of the Higher Education sector in Wales. It is part funded by the Welsh Government\u2019s European Social Fund (ESF) convergence programme for West Wales and the Valleys. NS (University of Pretoria) received payment for the preparation of the data for this study. RT and EF are employed by World Rugby, which provided funding for this study. MC is in paid employment with Premiership Rugby Limited and was previously employed by the Rugby Football Union. SW has previously received research funding from World Rugby and the Rugby Football Union. SWW has received ongoing grant funding from World Rugby for a different research project. SPR has no conflicts of interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The data used for this study are not publicly available. Data sharing agreements, between contributing countries and the lead author\u2019s institution, allowed the collation of anonymous data but did not extend to making this publicly available given restrictions from individual country governing bodies.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data"}},{"value":"Player consent for the primary data collections was previously granted in each respective country that contributed to the study. Data sharing agreements were obtained for each country to share anonymised and de-identified data with the lead author\u2019s institution, the University of Bath. Ethical approval for the study was granted by the Research Ethics Approval Committee for Health, University of Bath (reference: EP 19\/20 028). The study was performed in accordance with the standards of ethics outlined in the Declaration of Helsinki.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All players in this study provided informed consent to their respective unions responsible for collecting injury data in their country.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"KAS, MC, EF, and RT conceived the study idea and methodology. SK, SWW, and MC collected and verified English team injury data. ISM, CLB, and PM collected and verified Welsh team injury data, KQ collated and verified New Zealand team injury data. WM, LF, and ERdC collected and verified Australian team injury data. CR and NS collected and verified South Africa team injury data. SPR collated and analysed data from all countries, and SW contributed to statistical analysis. SPR and KAS drafted the manuscript, and all other authors provided critical revisions and interpretation of the data. All authors have approved the final version to be published.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}