The Serious Injury protocol is already one of these initiatives. Research is important to measure the outcome measures of change and effect and also provides scientific credibility to the programme.

BokSmart has already surveyed the current knowledge, attitudes and behaviours of players regarding rugby safety, injury prevention and injury management at secondary/high school level and at senior club level around the country. Measuring the change in these measures will also provide insight into whether the information provided to the coaches and referees are indeed getting to the players.

Additionally, what makes BokSmart unique in South Africa is that we have used more than 34 experts to develop the program content and that every guideline document provided has a supporting, researched evidence-base, has been peer-reviewed and edited.

Medical care and first aid: an interassociation consensus framework for organised non-elite sport during the COVID-19 pandemic
Lisa Hodgson, Gemma Phillips, Robin Terence Saggers , Sanjay Sharma, Michael Papadakis, Clint Readhead, Charlotte M Cowie, Andrew Massey ,Richard Weiler, Prabhat Mathema, Jo Larkin, Jonathan Gordon, John Maclean, Michael Rossiter, Niall Elliott , Jonathan Hanson, Simon Spencer, Rod Jaques, Jon Patricios (2021)
Br J Sports Med 2021;0:1–12. Published Online First: 22 February 2021. doi: 10.1136/bjsports-2020-103622

SARU Youth Week Injury Surveillance Report 2019
Paul, L., Readhead, C., Viljoen, W. and Lambert, M. (2020).
S Afr J Sports Med 2020;32:1-28; DOI: 10.17159/2078-516X/2020/v32i1a9257

Ankle osteoarthritis and its association with severe ankle injuries, ankle surgeries and health-related quality of life in recently retired professional male football and rugby players: a cross-sectional observational study
Liam D. A. Paget, Haruhito Aoki, Simon Kemp, Mike Lambert, Clint Readhead, Keith A Stokes, Wayne Viljoen, Gustaaf Reurink, Johannes L Tol, Gino M M J Kerkhoffs, Vincent Gouttebarge (2020). 
BMJ Open 2020;10:e036775. doi:10.1136/bmjopen-2020-036775

The Currie Cup Premiership Competition Injury Surveillance Report 2014-2019
Starling, L., Readhead, C., Viljoen, W. and Lambert, M. (2020). 
S Afr J Sports Med 2020;32:1-43. DOI:10.17159/2078-516X/2020/v32i1a8560

Consensus on a video analysis framework of descriptors and definitions by the Rugby Union Video Analysis Consensus group
Sharief Hendricks, Kevin Till, Steve den Hollander, Trevor N Savage, Simon P Roberts, Gregory Tierney, Nicholas Burger, Hamish Kerr, Simon Kemp, Matthew Cross, Jon Patricios, Andrew J McKune, Mark Bennet, Andy Rock, Keith A Stokes, Alex Ross, Clint Readhead, Kenneth L Quarrie, Ross Tucker, Ben Jones (2019) 
Br J Sports Med Epub ahead of print: doi:10.1136/bjsports-2019-101293

Impact of concussion and severe musculoskeletal injuries on the onset of mental health symptoms in male professional rugby players: a 12-month study
Özgür Kilic, Phil Hopley, Gino M M J Kerkhoffs, Mike Lambert, Evert Verhagen, Wayne Viljoen, Paul Wylleman, Vincent Gouttebarge (2020)
BMJ Open Sport & Exercise Medicine 2019;5:e000693. doi:10.1136/ bmjsem-2019-000693

The South African Rugby Union Youth Weeks Injury Surveillance Report 2018
Starling, L., Readhead, C., Viljoen, W. and Lambert, M. (2019)
S Afr J Sports Med 2019;31:1-19. DOI: 10.17159/2078-516X/2019/v31i1a6365

The Currie Cup Premiership Competition Injury Surveillance Report 2014 – 2018
Starling, L., Readhead, C., Viljoen, W. and Lambert, M. (2019). 
S Afr J Sports Med 2019;31:1-47. DOI:10.17159/2078-516X/2018/v31i1a6532

QUALITY OF LIFE AMONG INDIVIDUALS WITH RUGBY-RELATED SPINAL CORD INJURIES IN SOUTH AFRICA: A DESCRIPTIVE CROSS-SECTIONAL STUDY
M. Badenhorst, J.C Brown, M. Lambert, W. van Mechelen, E. Verhagen (2018). BMJ Open 2018; 8: e020890. 
doi:10.1136/bmjopen-2017-020890

‘IN A BLINK OF AN EYE YOUR LIFE CAN CHANGE’: EXPERIENCES OF PLAYERS SUSTAINING A RUGBY-RELATED ACUTE SPINAL CORD INJURY
M. Badenhorst, E. Verhagen, M. Lambert, W. van Mechelen, J.C Brown (2018).
Injury Prevention Published Online First: 05 July 2018. doi: 10.1136/injuryprev-2018-042871

The Currie Cup Premiership Competition Injury Surveillance Report 2014 – 2017 
Starling, L., Readhead, C., Viljoen, W., Brown, J., Sewry, N., and Lambert, M. (2018). 
S Afr J Sports Med 2018;30:1-42. DOI: 10.17159/2078-516X/2018/v30i1a5720

NON-SANCTIONING OF ILLEGAL TACKLES IN SOUTH AFRICAN YOUTH COMMUNITY RUGBY 
J.C. Brown, S.J. Boucher, M. Lambert, W. Viljoen, C. Readhead, S. Hendricks, W.J. Kraak (2017). 
Journal of Science and Medicine in Sport

SYMPTOMS OF COMMON MENTAL DISORDERS IN PROFESSIONAL RUGBY: AN INTERNATIONAL OBSERVATIONAL DESCRIPTIVE STUDY
Vincent Gouttebarge, Phil Hopley, Gino Kerkhoffs, Evert Verhagen, Wayne Viljoen, Paul Wylleman, Mike I. Lambert (2017). 
Published online: 2017 | Int J Sports Med.

TRENDS IN TIME-LOSS INJURIES DURING THE 2011-2016 SOUTH AFRICAN RUGBY YOUTH WEEKS
Nicola Sewry, Evert Verhagen, Mike Lambert, Willem van Mechelen, Jarred Marsh, Clint Readhead, Wayne Viljoen, James Brown (2018). 
Scandinavian Journal of Medicine and Science in Sports. Scand J Med Sci Sports.

TACKLE TECHNIQUE OF RUGBY UNION PLAYERS DURING HEAD IMPACT TACKLES COMPARED TO INJURY FREE TACKLES
Demi Davidow, Ken Quarrie, Wayne Viljoen, Nicholas Burger, Clint Readhead, Mike Lambert, Ben Jones & Sharief Hendricks (2018). 
Journal of Science and Medicine in Sport 21 (2018) 1025–1031.

A 12-MONTH PROSPECTIVE COHORT STUDY OF SYMPTOMS OF COMMON MENTAL DISORDERS AMONG PROFESSIONAL RUGBY PLAYERS
Vincent Gouttebarge PhD, Philip Hopley PhD, Gino Kerkhoffs MD PhD, Evert Verhagen PhD, Wayne Viljoen PhD, Paul Wylleman PhD, Mike Lambert PhD (2018). 
European Journal of Sport Science.

SEASONAL TIME-LOSS MATCH INJURY RATES AND BURDEN IN SOUTH AFRICAN UNDER-16 RUGBY PLAYERS
Nicola Sewry, Evert Verhagen, Mike Lambert, Willem van Mechelen, Clint Readhead, Wayne Viljoen, James Brown (2018). 
Journal of Science and Medicine in Sport (J Sci Med Sport) 2018 Jun 19. pii: S1440-2440(18)30258-5. doi: 10.1016/j.jsams.2018.06.007. [Epub ahead of print]

‘VisionZero’ – is it achievable for rugby-related catastrophic injuries in South Africa? 
James Brown, Wayne Viljoen, Clint Readhead, Gail Baerecke, Mike Lambert, Caroline F Finch.
BJSM Online First

A comparison of catastrophic injury incidence rates by Provincial Rugby Union in South Africa
Marelise Badenhorst, Evert A.L.M. Verhagen, Willem van Mechelen, Michael I. Lambert, Wayne Viljoen, Clint Readhead, Gail Baerecke, James C. Brown.
J Sci Med Sport (2017)

Mechanisms and factors associated with tackle-related injuries in South African Youth Rugby Union Players
Nicholas Burger, Mike Ian Lambert, Wayne Viljoen, James Craig Brown, Clint Readhead, Steve den Hollander and Sharief Hendricks.
The American Journal of Sports Medicine, DOI: 10.1177/0363546516677548
Am J Sports Med. 2017 Feb;45(2):278-285. doi: 10.1177/0363546516677548. Epub 2016 Dec 21

Back to basics with some new tools: First ensure the safety of sporting environment 
Caroline F Finch, James C Brown, Clint Readhead, Mike Lambert, Wayne Viljoen. 
BJSM Online First, published on November 25, 2016 as 10.1136/bjsports-2016-097043

Exercise-Based Interventions for Injury Prevention in Tackle Collision Ball Sports: a systematic review 
Nicola Sewry, Evert Verhagen, Mike Lambert, Willem van Mechelen, Wayne Viljoen, Clint Readhead & James Brown. 
Sports Medicine. DOI 10.1007/s40279-017-0704-4

Coach-directed education is associated with injury-prevention behaviour in players: an ecological cross-sectional study
James C Brown, Sugnet Gardner-Lubbe, Michael Ian Lambert, Willem van Mechelen, Evert Verhagen. 
BJSM Online First, published on November 25, 2016 as 10.1136/bjsports-2016-096757

The effectiveness of the nationwide BokSmart rugby injury prevention program on catastrophic injury rates 
Brown, J.C, Verhagen, E, Knol, D, Van Mechelen, W and Lambert, M.I
Scand. J. Med Sci Sports 2015: Online 15th February

Contact technique and concussions in the South African under-18 Coca-Cola Craven Week rugby tournament 
Hendricks, S., O' Connor, S., Lambert, M., Brown, J. C., McFie, S., Burger, N., Readhead, C., & Viljoen, W
European Journal of Sports Sciences 2015; 15: 6.

Are we currently underestimating the risk of scrum-related neck injuries in rugby union front-row players? [CONFERENCE ABSTRACT] 
Brown, JC, Lambert M, Hendricks S, Readhead C, Verhagen E, Burger N, Viljoen W.
Br J Sports Med. 2014; 48:574

Improvements in injury prevention behaviours of rugby union players associated with BokSmart intervention programme [CONFERENCE ABSTRACT] 
J Brown, M Lambert, S Lubbe, W Van Mechelen, E Verhagen
Br J Sports Med. 2014; 48:574

The effectiveness of the BokSmart intervention: the association between knowledge, education and perceptions and injury prevention behaviour in rugby union players [CONFERENCE ABSTRACT] 
Brown J, Lubbe S, Lambert M, Van Mechelen W, Verhagen E
Br J Sports Med. 2014; 48:574

Incidence and Factors Associated With Concussion Injuries Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Youth Week Tournaments 
Sarah McFie, James Brown, Sharief Hendricks, Michael Posthumus, Clint Readhead, Mike Lambert, Alison September, Wayne Viljoen
Clin J Sport Med 2015;0:1–7 DOI: 10.1097/JSM.0000000000000276

Tackle technique and tackle-related injuries in high-level South African Rugby Union under-18 players: real-match video analysis 
Nicholas Burger, Michael I Lambert, Wayne Viljoen, James C Brown, Clint Readhead, Sharief Hendricks
Br J Sports Med. 2016; Online first 18 January 2016

Response to: ‘The search for size: a doping risk factor in adolescent rugby’ 
Clint Readhead 
Br J Sports Med 2015;0:1.doi:10.1136/bjsports-2015-095202

The BokSmart intervention programme is associated with improvements in injury prevention behaviours of rugby union players: an ecological cross-sectional study 
Brown JC, Gardner-Lubbe S, Lambert MI, Van Mechelen W, Verhagen E.
Injury Prevention 2014 Nov 21. pii: injuryprev-2014-041326. doi: 10.1136/injuryprev-2014-041326. [Epub ahead of print]

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study
Nicholas Burger, Prof. Mike I. Lambert, Dr. Wayne Viljoen, Mr. James C. Brown , Mr. Clint Readhead, Dr. Sharief Hendricks
BMJ Open 2014; 4:e005556 OPEN ACCESS ARTICLE

The economic burden of time-loss injuries to elite youth players participating in week-long Rugby tournaments? 
Mr. James C. Brown, Dr. Wayne Viljoen, Prof. Mike I. Lambert, Mr. Clint Readhead, Prof. Willem Van Mechelen, Ms. Chelsea Fuller, Dr. Evert Verhagen
Journal of Science and Medicine in Sport, DOI: 10.1016/j.jsams.2014.06.015

The state of women’s rugby union in South Africa: Recommendations for long-term participant development 
Michael Posthumus
S Afr J SM 2013;25(1):28-35. DOI:10.7196/SAJSM.461

BokSmart - implementing a National Rugby Safety Programme 
Wayne Viljoen, Jon Patricios
S Afr J SM 2013;25(1):3-5. DOI:10.7196/SAJSM.460 This article was reproduced with permission from the BMJ Group. It was first published in the British Journal of Sports Medicine: Viljoen W, Patricios J. BokSmart – implementing a National Rugby Safety Programme. Br J Sports Med 2012;46:492-493. [http://dx.doi.org/10.1136/bjsports-2012-091278]

Are we currently underestimating the risk of scrum-related neck injuries in rugby union front-row players? 
James C Brown, Mike I Lambert, Sharief Hendricks, Clint Readhead, Evert Verhagen, Nicholas Burger, Wayne Viljoen 2014
Br J Sports Med doi:10.1136/bjsports-2013-092869

An evidence-driven approach to scrum law modifications in amateur rugby played in South Africa 
Sharief Hendricks, Mike I Lambert, James C Brown, Clint Readhead, Wayne Viljoen
Br J Sports Med doi:10.1136/bjsports-2013-092877

The incidence and severity of injuries at the 2011 South African Rugby Union (SARU) Youth Week tournaments 
James C Brown, Evert Verhagen, Wayne Viljoen, Clint Readhead, Willem Van Mechelen, Sharief Hendricks, Mike I Lambert (2012).
S Afr J SM 2012;24(2):49-54.

BokSmart – implementing a National Rugby Safety Programme 
Viljoen W and Patricios J
BJSM Online. First, published on May 19, 2012 as 10.1136/bjsports-2012-0912785

BokSmart: Pre-participation screening of rugby players by coaches based on internationally accepted medical standards
JS Patricios, MB BCh, MMedSci (Sheffield), FACSM, FFSEM (UK), RM Collins, MB BCh, MSc (Sports Med)
SAJSM Vol 22, No. 3, 2010, pg. 62-65

Long-term player development in rugby – how are we doing in South Africa?
Mike I Lambert, PhD, Justin Durandt, BSc (Med) Hons (Exercise Science) Biokinetics
SAJSM Vol 22, No. 3, 2010, pg. 67-68

Training volume and injury incidence in a professional rugby union team
Wayne Viljoen (PhD, CSCS)
Colleen J Saunders (BSc (Med) Hons (Exercise Science))
Greg D Hechter (BA Hons (Biokinetics))
Kerith D Aginsky (PhD)
Helen B Millson (MPhil (Sports Physiotherapy))
SAJSM vol 21 No. 3 2009

BokSmart: Safe and effective techniques in rugby union 
Michael Posthumus (BSc(Med)(Hon) Exercise Science)
Wayne Viljoen (PhD)
SAJSM vol 20 No. 3 2008

BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core 
Neil Hopkins (BSc (Med) (Hons) Exercise Science (Biokinetics))
Wayne Viljoen (PhD)
SAJSM vol 20 No. 4 2008

BokSmart: medical management of suspected serious acute spinal cord injuries in rugby players 
Robert N Dunn (MB ChB, MMed (Orth), FCS(SA) Orth)
SAJSM vol 21 No. 3 2009

The incidence of rugby-related catastrophic injuries (including cardiac events) in South Africa from 2008 to 2011: a cohort study 
James Craig Brown, Mike I Lambert, Evert Verhagen, Clint Readhead, Willem van Mechelen, Wayne Viljoen (2013)
BMJ Open 2013; 3:e002475 doi:10.1136/bmjopen-2012-002475

Characteristics of an ‘effective’ tackle outcome in Six Nations rugby 
Michele van Rooyen, Nabeel Yasin and Wayne Viljoen 2012
European Journal of Sport Science, DOI:10.1080/17461391.2012.738710

More than 50% of players sustained a time-loss injury (>1 day of lost training or playing time) during the 2012 Super Rugby Union Tournament a prospective cohort study of 17 340 player-hours 
Martin P Schwellnus, Alan Thomson, Wayne Derman, Esme Jordaan, Clint Readhead, Rob Collins, Ian Morris, Org Strauss, Ewoudt Van der Linde, Arthur Williams
BJSM Online First, published on June 30, 2014 as 10.1136/bjsports-2014-093745

Trainability of Junior Rugby Union players 
S Hendricks 2012
South African Journal of Sports Medicine

Elite athletes travelling to international destinations >5 time zone differences from their home country have a 2-3 fold increased risk of illness 
Schwellnus M, Derman W, Lambert M, Readhead C et al. 2012
British Journal of Sports Medicine

Illness during the 2010 Super 14 Rugby Union Tournament – A prospective study involving 22676 player days 
Schwellnus M, Derman W, Lambert M, Readhead C et al. 2012
British Journal of Sports Medicine