The effectiveness of the nationwide B ok S mart rugby injury prevention program on catastrophic injury rates

Rugby U nion (“rugby”) participants have a higher than average risk of injury compared with participants of other popular team sports. B ok S mart, a nationwide injury prevention program was launched in S outh A frica in mid‐2009, with the goal of reducing catastrophic head/neck (serious) injuries in players. The program provides injury prevention information to coaches and referees. This study investigated if B ok S mart has been associated with a reduction in these injuries. The B ok S mart program collected data on all S outh A frican rugby‐related serious injuries since 2008. Using a P oisson regression, injury numbers were compared pre‐ B ok S mart (2008–2009) to the years post‐implementation (2010–2013). Player numbers were assumed to be constant throughout this evaluation: junior = 529 483; senior = 121 663. In junior players, the “post‐ B ok S mart” period had 2.5 less annual serious injuries than “pre‐ B ok S mart” (incidence rate ratio: 0.6, 95% confidence interval: 0.5–0.7, P  < 0.000). In contrast, there was no significant difference in these periods in seniors. The absence of effect in seniors may be a result of fewer players or of differences in effectiveness of B ok S mart in this group – future studies should investigate these questions.