{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T18:46:24Z","timestamp":1776883584249,"version":"3.51.2"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Sport\u2010related concussion (SRC) is one of the most frequent injuries in rugby union and remains a public health concern owing to short\u2010, medium\u2010, and long\u2010term consequences. Although SRC epidemiology is well described internationally, national data from Spanish rugby union are lacking. A census\u2010based surveillance study was conducted across one competitive season including all official matches from the men's senior (Divisi\u00f3n de Honor), women's senior (Liga IBERDROLA), and men's under\u201023 (CNM23) competitions. SRC was defined according to the 6th International Consensus on Concussion in Sport and all matches were conducted in accordance with World Rugby's Recognize and Remove protocol. Case identification combined medical reporting with independent video review. Incidence and burden were calculated per 1000 player\u2013match\u2013hours (PMH). Time to graduated return\u2010to\u2010play (GRTP) was analyzed using Kaplan\u2013Meier methods, and determinants of GRTP duration were examined using Gamma regression. Across 317 matches (12\u2009680 PMH), 80 SRCs were identified, giving an incidence of 6.31\/1000 PMH (95% CI, 4.9\u20138.0). Incidence was highest in Divisi\u00f3n de Honor, followed by Liga IBERDROLA and CNM23 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Burden was 92\u2009days lost\/1000 PMH. Median GRTP duration was 14\u2009days (95% CI: 13.1\u201314.9), with no differences between competitions or positions. Longer GRTP duration was associated with ruck events, fourth\u2010quarter injuries, sex, and previous SRC history. The incidence and burden differed by competition level, whereas recovery duration was influenced by match context and intrinsic factors. The GRTP durations observed suggest variability in protocol implementation and highlight the need for consistent supervision, following ruck\u2010related and late\u2010match injuries. Findings support individualized GRTP pathways to optimize return\u2010to\u2010play outcomes.\n                  <\/jats:p>","DOI":"10.1111\/sms.70267","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T04:36:06Z","timestamp":1774413366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concussion in Spanish Rugby Union (\n                    <scp>XV<\/scp>\n                    ): A National Analysis of Incidence, Burden, and Determinants of Return to Play"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7269-8476","authenticated-orcid":false,"given":"Mario","family":"Iglesias\u2010Mu\u00f1iz","sequence":"first","affiliation":[{"name":"Unfallchirurgie Und Sporttraumatologie Theresienkrankenhaus Mannheim  Mannheim Germany"},{"name":"Medizinische Fakult\u00e4t Universit\u00e4t Heidelberg  Heidelberg Germany"},{"name":"Facultad de Medicina y Ciencias de la Salud Universidad de Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2542-4152","authenticated-orcid":false,"given":"Roberto","family":"Murias\u2010Lozano","sequence":"additional","affiliation":[{"name":"Facultad HM de Ciencias de la Salud Universidad Camilo Jos\u00e9 Cela  Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria HM Hospitales  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6651-2672","authenticated-orcid":false,"given":"Guillermo","family":"Iglesias\u2010Mu\u00f1iz","sequence":"additional","affiliation":[{"name":"Facultad de Medicina y Ciencias de la Salud Universidad de Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5986-8432","authenticated-orcid":false,"given":"Luis","family":"de Sousa\u2010de Sousa","sequence":"additional","affiliation":[{"name":"Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-0018","authenticated-orcid":false,"given":"Jos\u00e9 A.","family":"Vega","sequence":"additional","affiliation":[{"name":"Facultad de Medicina y Ciencias de la Salud Universidad de Oviedo  Oviedo Spain"},{"name":"Facultad de Ciencias de la Salud Universidad Aut\u00f3noma de Chile  Santiago Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Antonio","family":"Garc\u00eda\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Facultad de Medicina y Ciencias de la Salud Universidad de Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Mendia","sequence":"additional","affiliation":[{"name":"Interventional Radiology Lead, Anaesthetic Departament University Hospitals Coventry and Warwickshire NHS Trust  Coventry UK"},{"name":"England Students Rugby Football Union (RFU)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Carlos","family":"Sal\u00f3","sequence":"additional","affiliation":[{"name":"Servicio de Traumatolog\u00eda y Cirug\u00eda Ortop\u00e9dica Hospital Universitario Arnau de Vilanova  L\u00e9rida Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-9136","authenticated-orcid":false,"given":"Pablo","family":"Garc\u00eda\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda Universidad Complutense de Madrid  Madrid Spain"},{"name":"Grupo InPhysio Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC)  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102023\u2010106898"},{"issue":"3","key":"e_1_2_13_3_1","first-page":"228","article-title":"The Neurometabolic Cascade of Concussion","volume":"36","author":"Giza C. 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