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Quality of life among individuals with rugby-related spinal cord injuries in South Africa: a descriptive cross-sectional study
  1. Marelise Badenhorst1,2,
  2. James Craig Brown1,2,
  3. Mike I Lambert1,2,
  4. Willem Van Mechelen1,2,3,4,
  5. Evert Verhagen1,2,5
  1. 1 Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
  2. 2 Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
  3. 3 School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
  4. 4 School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
  5. 5 Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
  1. Correspondence to Dr Evert Verhagen; e.verhagen{at}


Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework.

Design Descriptive cross-sectional study.

Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players’ Fund database.

Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study.

Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses.

Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001).

Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.

  • adult neurology
  • rehabilitation medicine
  • sports medicine

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  • Contributors MB conducted the data collection and was involved in conceptualising the manuscript; she also conducted statistical analyses and wrote the initial drafts of the manuscript. EV and JCB were involved in the statistical analyses and interpretation of the results. All authors were involved in conceptualising and editing drafts of the manuscript.

  • Funding MB’s PhD is funded by the Vrije Universiteit Amsterdam/National Research Foundation (NRF) South Africa Desmond Tutu Doctoral Scholarship, administered through South Africa Vrije Universiteit Strategic Alliances (SAVUSA), the Oppenheimer Memorial Trust and Zuid-Afrikahuis Study foundation for South African students.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical clearance for the study was obtained from the University of Cape Town Human Research Ethics Committee (HREC REF: 893/2015).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are published, and therefore there is no additional data available. Owing to the sensitive nature of the information and appropriate medical ethics, access to the raw data set will be reviewed on request.

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