710 MEP126 – Sideline physiotherapy support and pre-season baseline testing are associated with improved compliance to New Zealand rugby’s community concussion management pathway

AbstractBackground Every year in New Zealand (NZ) an estimated 10 per 1000 rugby players seek medical care for a concussion injury sustained at an average cost of NZ$1700 per claim. In response, NZ Rugby (NZR) developed a community concussion initiative to operationalize best practice guidelines for managing sport-related concussions.Objective To describe demographic and/or contextual factors that were associated with compliance to NZR's community concussion management pathway (CMP).Design Prospective cohort study.Setting Community rugby in NZ.Participants 4724 community rugby players. Intervention This study followed the concussion management journey of players throughout 2020 and 2021 rugby seasons. Key steps in the CMP were analysed encompassing attendance to diagnosis, a medical clearance assessment and adherence to the recommended standdown period. Players' age, sex, ethnicity, having a team physiotherapist and completing a pre-season baseline test were examined relative to compliance to each stage of the CMP. Multivariate logistic regression models explored the association between independent variables and compliance steps.Results Over the two seasons 383 concussions were reported, with an average incidence rate of 16.4 concussion per 1000 player match hours. Age, ethnicity, and sex did not influence compliance to the CMP steps. The odds of a player having a medical diagnosis were increased by having a team physiotherapist (OR 3.12; p<0.001). The odds of a player obtaining medical clearance were significantly improved if their team had a physiotherapist (OR 2.02; p=0.02) and a pre-season baseline test (OR 2.48; p<0.001. The odds of a player adhering to the appropriate stand-down were significantly improved by having a baseline test (OR 2.94; p<0.001).Conclusion Having a team physiotherapist and completing a pre-season baseline test were associated with improved CMP compliance. These contextual factors should be promoted to community teams by relevant governing bodies to improve overall player welfare following a rugby-related concussion.