Sport concussion assessment in New Zealand high school rugby players: a collaborative approach to the challenges faced in primary care

Primary Objective To describe the collaborative development of a New Zealand Rugby Concussion Assessment (NZRCA) for primary care and to provide normative baseline data from a representative group of high school rugby players. Methods This study, conducted over the 2018 and 2019 community rugby season where players were baseline tested during the pre- or start of season period. Results Data were collected from 1428 players (males n = 1121, females n = 307) with a mean age of 15.9 +/- 1.4 years. The mean +/- SD symptom severity score was 11.3 +/- 8.6, the mean number of endorsed symptoms was 8.5 +/- 5.3 and the percentage feeling "normal" was 80.2 +/- 15.3%. Only 5.3% of players reported no symptoms at baseline. The most common reported were: 'distracted easily' (72.5%), 'forgetful' (68.5%), and 'often tired' (62.6%). None of the participants achieved a perfect score for the SAC50. The majority of participants (89.7%) passed the tandem gait test with a time of 12.2 +/- 1.7 seconds. Age, gender, and ethnicity were associated with NZRCA performance; albeit weakly. Conclusion This study provides normative reference values for high-school rugby players. These data will aid healthcare providers in their identification of suspected concussion in the absence of individualized baselines.