Since its introduction in 2001, all New Zealand rugby coaches and referees have taken part in the RugbySmart programme. The goals of the programme are to educate those involved in rugby about physical conditioning, injury management, and safe techniques during contact phases. This ecological study assessed the effect of RugbySmart on the frequency of serious spinal injury resulting in permanent disablement amongst rugby union players. Based on historical data, the predicted number of spinal injuries for the years 2001 to 2005 was 18.9, whereas the actual number was 8 (relative rate 0.46, 95% Cl 0.19 to 1.14). A single injury arose from scrums compared to 9 injuries forecast (relative rate 0.11 , 95% Cl 0.02 to 0.74), and in other phases of play 7 injuries were observed compared to 9 predicted (relative rate 0.83, 95% Cl 0.29 to 2.36). RugbySmart has been associated with a reduction in the rate of disabling spinal injuries amongst New Zealand players of rugby union.
