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Abstract

Background:

Sport-related concussion (SRC) has been associated with cognitive impairment, depression, and chronic traumatic encephalopathy. American football is the most popular sport among males in the United States and has one of the highest concussion rates among high school sports. Measured head impacts and concussions are approximately 4 times more common in contact practices compared with noncontact practices. The Wisconsin Interscholastic Athletic Association passed new rules defining and limiting contact during practice before the 2014 football season.

Purpose:

To determine if the SRC rate is lower after a rule change that limited the amount and duration of full-contact activities during high school football practice sessions.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 2081 high school football athletes enrolled and participated in the study in 2012-2013 (before the rule change), and 945 players participated in the study in 2014 (after the rule change). Players self-reported previous concussion and demographic information. Athletic trainers recorded athlete exposures (AEs), concussion incidence, and days lost for each SRC. Chi-square tests were used to compare the incidence of SRC in prerule 2012-2013 seasons with the incidence in the postrule 2014 season. Wilcoxon rank sum tests were used to determine differences in days lost because of SRC.

Results:

A total of 67 players (7.1%) sustained 70 SRCs in 2014. The overall rate of SRC per 1000 AEs was 1.28 in 2014 as compared with 1.58 in 2012-2013 (P = .139). The rate of SRC sustained overall in practice was significantly lower (P = .003) after the rule change in 2014 (15 SRCs, 0.33 per 1000 AEs) as compared with prerule 2012-2013 (86 SRCs, 0.76 per 1000 AEs). There was no difference (P = .999) in the rate of SRC sustained in games before (5.81 per 1000 AEs) and after (5.74 per 1000 AEs) the rule change. There was no difference (P = .967) in days lost from SRC before (13 days lost [interquartile range, 10-18]) and after (14 days lost [interquartile range, 10-16]) the rule change.

Conclusion:

The rate of SRC sustained in high school football practice decreased by 57% after a rule change limiting the amount and duration of full-contact activities, with no change in competition concussion rate. Limitations on contact during high school football practice may be one effective measure to reduce the incidence of SRC.

Keywords

concussion head injury football epidemiology injury prevention pediatric sports medicine

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References

2011 Wisconsin Act 172. 2012;4(1):119-120.

Bailey

. Physical education and sport in schools: a review of benefits and outcomes. J Sch Health. 2006;76:397-401.

Broglio

Martini

Kasper

Eckner

Kutcher

. Estimation of head impact exposure in high school football: implications for regulating contact practices. Am J Sports Med. 2013;41(12):2877-2884.

Broglio

Sosnoff

Shin

Alcaraz

Zimmerman

. Head impacts during high school football: a biomechanical assessment. J Athl Train. 2009;44(4):342-349.

Broglio

Williams

Connor

KLO

Goldstick

. Football players’ head-impact exposure after limiting of full-contact practices. J Athl Train. 2016;51(7):511-518.

Dompier

Kerr

Marshall

, et al. Incidence of concussion during practice and games in youth, high school, and collegiate American football players. JAMA Pediatr. 2015;169(7):659-665.

Guskiewicz

Marshall

Bailes

, et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005;57(4):719-726.

Guskiewicz

Marshall

Bailes

, et al. Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc. 2007;39(6):903-909.

Guskiewicz

Weaver

Padua

Garrett

Jr.

Epidemiology of concussion in collegiate and high school football players. Am J Sports Med. 2000;28(5):643-650.

10.

Kim

Skorton

. Report Regarding the Ivy League Review of Concussions in Football. League

Ivy

, ed. Princeton, NJ: Council of Ivy League Presidents.

11.

Langlois

Rytland-Brown

Wald

. The epidemiology and impact of traumatic brain injury. J Head Trauma Rehabil. 2006; 21(5):375-378.

12.

Marar

McIlvain

Fields

Comstock

. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40(4):747-755.

13.

McGuine

Hetzel

McCrea

Brooks

. Protective equipment and player characteristics associated with the incidence of sport-related concussion in high school football players: a multifactorial prospective study. Am J Sports Med. 2014;42(10):2470-2478.

14.

McKee

Alosco

Huber

. Repetitive head impacts and chronic traumatic encephalopathy. Neurosurg Clin N Am. 2016; 27(4):529-535.

15.

McLendon

Kralik

Grayson

Golomb

. The controversial second impact syndrome: a review of the literature. Pediatr Neurol. 2016;62(2016):9-17.

16.

National Federation of High Schools. High School Athletics Participation Survey. https://www.nfhs.org/ParticipationStatistics/ParticipationStatistics/. Accessed December 14, 2018.

17.

Pfister

Hagel

Ghali

Ronksley

. The incidence of concussion in youth sports: a systematic review and meta-analysis. Br J Sports Med. 2016;50(5):292-297.

18.

Powell

Barber-Foss

. Traumatic brain injury in high school athletes. JAMA. 1999;282(10):958-963.

19.

Practice parameter: the management of concussion in sports (summary statement). Neurology. 1997;48:581-585.

20.

R Core Team. A language and environment for statistical computing. https://www.r-project.org/. Published 2016.

21.

Randolph

Millis

Barr

, et al. Concussion symptom inventory: an empirically derived scale for monitoring resolution of symptoms following sport-related concussion. Arch Clin Neuropsychol. 2009;24(3):219-229.

22.

Sosin

Sniezek

Thurman

. Incidence of mild and moderate brain injury in the United States, 1991. Brain Inj. 1996;10(1):47-54.

23.

Taranto

Fishman

Garvey

Perlman

Benjamin

Ross

. Public attitudes and knowledge about youth sports participation and concussion risk in an urban area. J Natl Med Assoc. 2018;110(6):635-643.

24.

Wiebe

D’Alonzo

Harris

Putukian

Campbell-McGovern

. Association between the experimental kickoff rule and concussion rates in Ivy League football. JAMA. 2018;320(19):2035-2036.

25.

Wisconsin Interscholastic Athletic Association. WIAA football player on player contact. https://www.wiaawi.org/Portals/0/PDF/Health/WIAAFootballPlayeronPlayerContact.pdf. Accessed December 14, 2018.

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Effect of a New Rule Limiting Full Contact Practice on the Incidence of Sport-Related Concussion in High School Football Players

Abstract

Background:

Purpose:

Study Design:

Methods:

Results:

Conclusion:

Keywords

Get full access to this article

References

Supplementary Material