Development of an integrated injury prevention and rehabilitation model for rugby and long-distance running: A qualitative consensus approach

Background Sports injuries remain a significant challenge to athletes' health, performance, and long-term participation, particularly in high-contact and endurance sports. Existing prevention frameworks often lack sport-specific adaptability and integration with rehabilitation. Objectives This study aimed to develop and refine an Integrated Injury Prevention and Rehabilitation Model (IIPRM) through a qualitative, multi-phase consensus process. Methods A three-stage, sequential qualitative design was used. Stage 1 was a scoping review of injury risks and prevention strategies in rugby and long-distance running to identify core concepts for the model. Stage 2 used a modified e-Delphi with experts (n=22; three rounds), with consensus predefined as ≥75% agreement; panel retention was 100% across Rounds 1–3 and 18.2% attrition in Round 4. Stakeholder focus groups (n=10) were used to refine clarity, feasibility, and contextual relevance. Stage 3 combined the final fourth Delphi round and focus-group feedback to build consensus and validate the model. Results Across Delphi rounds, 82% of items reached the ≥75% consensus threshold by Round 2, with remaining items achieving consensus in Round 3. The final IIPRM is a cyclical, athlete-centred framework integrating primary and secondary prevention through education, pre-participation screening, risk-targeted interventions, functional reintegration, and continuous monitoring. Stakeholder input prompted the inclusion of psychological readiness screening, enhanced recovery education, and seasonal alignment of interventions. Conclusion The IIPRM provides a conceptually practical and adaptable approach to injury prevention and rehabilitation, positioned to facilitate interdisciplinary collaboration and long-term athlete health. As the model has not yet been implemented or evaluated, future research should examine its feasibility, effectiveness, and transferability across sports.