886 MEP128 – Pre-season clinical outcomes informing concussion prevention in youth rugby players in Canada and South Africa

AbstractBackground Following sport-related concussion, a multifaceted evaluation is recommended. Performance on multifaceted clinical outcomes could inform cultural adaptations for prevention strategies.Objective To evaluate differences in preseason clinical measures by sex and location in youth Rugby Union ("rugby") players.Design Cross-sectional study that is a secondary analysis of two multisite international prospective cohort studies.Setting Youth rugby in Canada/South Africa.Participants A convenience sample of rugby players aged 11–18 years were invited to participate. A total of 610 youth rugby players (males=334, females=273, undisclosed=3) from Canada (n=547) and South Africa (n=63) participated. Assessment of Risk Factors Variables included sex (male/female) and geographical location (Canada/South Africa), with age grouping (<15,15/16,>17) as a covariate. Descriptive statistics were used to summarize baseline demographics. Linear, logistic regression, or a Mann-Whitney U-Test evaluated differences in outcomes by sex and location.Main Outcome Measurements Vestibulo-ocular reflex [head thrust test, dynamic visual acuity (DVA)]; Vestibular-Ocular Motor Screen; Cervical Spine [range of motion, cervical flexor endurance (CFE), cervical flexion rotation test, head perturbation test (HPT)]; and dynamic balance [advanced Functional Gait Assessment (aFGA)]. Results Males in South Africa performed better on cervical spine and balance outcomes [CFE (median difference=91.58s greater, z=11.13,p<0.01); aFGA (median score of 2.0 points better, z=4.61,p<0.01)], worse on DVA (median score 2 lines difference more, z=7.62,p<0.01), and had 3.72 (95%CI 1.99–6.99) greater odds of convergence distance >6cm (z=4.10,p<0.01) compared to males in Canada. Within Canada, females had a 5.11 (95%CI 2.48–7.76) seconds shorter CFE (t=3.81,p<0.01) and 2.40 (95%CI 1.62–3.55) times greater odds to score <8 on HPT (z=4.39,p<0.01) compared to males.Conclusions Differences exist in preseason clinical outcomes by location and sex. Further evaluation to understand the underlying physiological reason for these differences and the effect on concussion risk is needed. Understanding these potential differences will inform optimization of individually targeted concussion prevention strategies.