Micky Olutende, Anthony Muchiri Wangui, Maximilla Wanzala, Edwin Kadima Wamukoya


Objective: The objective of the study was to determine the level of concussion knowledge and attitudes among sub-elite rugby union players in Western Kenya. Design: The study was a descriptive cross-sectional study and Quantitative methods were adopted. Setting: The study was carried out in Western Kenya Sample: The respondents were Sub elite rugby players who were randomly sampled from various rugby clubs in the region (n = 209) Analysis: Data was analyzed through descriptive statistics, confirmatory factor analysis and one-way analysis of variance (ANOVA). Main outcome measures: Concussion knowledge and attitude Results: Results from the Confirmatory factor analysis yielded a 22-item two-factor structure. The results showed a non-significant chi-square result, therefore, indicating good fit, the goodness of fit index (GFI), comparative fit index (CFI), and incremental fit index (IFI) had valued above .90 hence indicating a good fit. Root mean square error of approximation (RMSEA) that normally exceeds .1 warrants rejecting the model, however, our value was  .05 indicating close fit. Cronbach’s alpha for the 14-items Knowledge scale and 8-items attitude scale were α = .702 and α = .728. Deleting construct items did not increase the alpha. The mean concussion knowledge score was 20.94 out of 27 (95% CI 20.7 to 21.2, ± 2.02), 90% (n=188) correctly said that there was a possible risk of death if a second concussion occurred before the first one had healed. 49.3% (n=103) correctly answered that people who have had one concussion were more likely to have another concussion. In addition, 71.3% (n=149) correctly answered that, in order to be diagnosed with a concussion, a person didn't have to be knocked out. However, only 30% (n=63) answered correctly that after a concussion occurs, brain imaging (e.g., CAT Scan, MRI, X-Ray, etc.) does not show visible physical damage (e.g., bruise, blood clot) to the brain. With regards to attitude, most players had a negative attitude (n=122, 58%), many rugby players (48.8%, n=102) strongly disagreed that they would continue playing the sport while also having a headache that resulted from a minor concussion. Many strongly agreed (58.9%, n=123) that coaches need to be extremely cautious when determining whether a rugby player should return to play. The majority strongly disagreed (75.1%, n=157) that concussions are less important than other injuries. The independent between-group ANOVA yielded a statistically significantly effect, F (3, 202) = 3.158, p = .026, ƞp2= .045. Thus, the null hypothesis of no significant differences in concussion knowledge among sub-elite rugby players of different National team caps was rejected, however, only 5% of the variance (small effect size) in knowledge was accounted for by group membership. Conclusion: Action should be taken to better educate athletes and to ensure a change in attitude, proper recognition and management of concussions.


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head injuries, education, symptoms, traumatic brain injury rugby, concussion, sport injuries, Western Kenya, knowledge, attitude, confirmatory factor analysis, sub elite

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