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Concussion Prevention

  • Kathleen M. WeberEmail author
  • Elizabeth B. Portin
Chapter
  • 21 Downloads

Abstract

The primary prevention of sport-related concussions (“SRCs”) has received significantly less scholarly attention from researchers and clinicians than other aspects of SRCs, such as SRC monitoring and management. Current research into strategies for primary concussion prevention focus on protective gear, proper technique, neck strengthening, rule changes, legislation, and education, especially in contact sports that pose the greatest SRC risk to participants, such as football, hockey, soccer, and rugby. To the frustration and surprise of many, such research has failed to prove the efficacy of the most seemingly obvious SRC prevention strategies in these areas. This is likely because there is no panacea to prevent SRCs, and no strategy is universally applicable across age, gender, and positions within the same sport. Ultimately, concussion prevention will require an overall shift in the attitudes of coaches, players, and spectators towards putting safety above competitiveness, for example, by promoting fair play rules and enforcing penalties for unsafe plays.

Keywords

Prevention strategies Safety Competitiveness Fair play Penalties Protective gear Technique Neck strengthening Rules Legislation Education 

References

  1. 1.
    Harmon KG, Drezner JA, Gammons M, et al. American medical society for sports medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15–26.CrossRefGoogle Scholar
  2. 2.
    Zuckerman SL, Reynolds BB, Yengo-Kahn AM, et al. A football helmet prototype that reduces linear and rotational acceleration with the addition of an outer shell. J Neurosurg. 2018:1–8.  https://doi.org/10.3171/2018.1.JNS172733.
  3. 3.
    Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med. 2017;51(12):978–84.CrossRefGoogle Scholar
  4. 4.
    Schneider DK, Grandhi RK, Bansal P, et al. Current state of concussion prevention strategies: a systematic review and meta-analysis of prospective, controlled studies. Br J Sports Med. 2017;51(20):1473–82.CrossRefGoogle Scholar
  5. 5.
    Nfl, nflpa release 2019 helmet laboratory testing performance results. States News Service. Apr 12, 2019.Google Scholar
  6. 6.
    McGuine TA, Hetzel S, McCrea M, Brooks MA. Protective equipment and player characteristics associated with the incidence of sport-related concussion in high school football players. Am J Sports Med. 2014;42(10):2470–8.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Haider AH, Saleem T, Bilaniuk JW, Barraco RD. An evidence-based review: efficacy of safety helmets in the reduction of head injuries in recreational skiers and snowboarders. J Trauma Acute Care Surg. 2012;73(5):1340–7.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Hagel BE, Pless IB, Goulet C, Platt RW, Robitaille Y. Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study. BMJ. 2005;330(7486):281–3.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Rowson S, Duma SM, Greenwald RM, et al. Can helmet design reduce the risk of concussion in football? J Neurosurg. 2014;120(4):919–22.CrossRefGoogle Scholar
  10. 10.
    Bland ML, Zuby DS, Mueller BC, Rowson S. Differences in the protective capabilities of bicycle helmets in real-world and standard-specified impact scenarios. Traffic Inj Prev. 2018;19(sup1):S163.CrossRefGoogle Scholar
  11. 11.
    Bland ML, McNally C, Rowson S. Differences in impact performance of bicycle helmets during oblique impacts. J Biomech Eng. 2018;140(9):91005.CrossRefGoogle Scholar
  12. 12.
    Delaney JS, Al-Kashmiri A, Drummond R, Correa JA. The effect of protective headgear on head injuries and concussions in adolescent football (soccer) players. Br J Sports Med. 2008;42(2):5; discussion 115.Google Scholar
  13. 13.
    Barnes A, Rumbold JL, Olusoga P. Attitudes towards protective headgear in UK rugby union players. BMJ Open Sport Exerc Med. 2017;3(1):e000255.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ganly M, McMahon JM. New generation of headgear for rugby: impact reduction of linear and rotational forces by a viscoelastic material-based rugby head guard. BMJ Open Sport Exerc Med. 2018;4(1):e000464.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Harmon KG, Clugston JR, Dec K, et al. American medical society for sports medicine position statement on concussion in sport. Br J Sports Med. 2019;53(4):213–25.CrossRefGoogle Scholar
  16. 16.
    Halstead ME, Walter KD, Moffatt K. Sport-related concussion in children and adolescents. Pediatrics. 2018;142(6):1.CrossRefGoogle Scholar
  17. 17.
    Greenhill DA, Navo P, Zhao H, Torg J, Comstock RD, Boden BP. Inadequate helmet fit increases concussion severity in american high school football players. Sports Health. 2016;8(3):238–43.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Centers for Disease Control and Prevention. CDC HEADS UP concussion and helmet safety.Google Scholar
  19. 19.
    Taylor K. The cost of high school football — dollars must be stretched to train, equip, feed teams. The Gadsden Times. 08/17/2016. https://www.gadsdentimes.com/news/20160817/cost-of-high-school-football%2D%2D-dollars-must-be-stretched-to-train-equip-feed-teams. Accessed 27 Sept 2019.
  20. 20.
    VICIS I. VICIS announces price reduction of ZERO1 helmet. PR Newswire. Jan 18, 2018. Available from: https://search.proquest.com/docview/1988489058.
  21. 21.
    Good sports. https://www.goodsports.org/about/. Accessed 27 Sept 2019.
  22. 22.
    Sports matter: Help save youth sports. https://www.sportsmatter.org. Accessed 27 Sept 2019.
  23. 23.
    The sports shed. https://thesportsshed.org. Accessed 27 Sept 2019.
  24. 24.
    Göpfert A, Van Hove M, Emond A, Mytton J. Prevention of sports injuries in children at school: a systematic review of policies. BMJ Open Sport Exerc Med. 2018;4(1):e000346.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Waldstein D. Safer batting helmet draws resistance from some players. New York Times. August 12, 2009:B11. https://www.nytimes.com/2009/08/13/sports/baseball/13helmet.html. Accessed 27 Sept 2019.
  26. 26.
    Mark Maske. NFL players, including tom brady, will have to be in approved helmets this season. https://search.proquest.com/docview/2208587151. Updated 2019.
  27. 27.
    Brophy M. NHL, NHLPA agree on mandatory visors https://www.nhl.com/news/nhl-nhlpa-agree-on-mandatory-visors/c-672983. Accessed 27 Sept 2019.
  28. 28.
    Kerr ZY, Yeargin S, Valovich McLeod TC, et al. Comprehensive coach education and practice contact restriction guidelines result in lower injury rates in youth american football. Orthop J Sports Med. 2015;3(7):2325967115594578.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Kerr ZY, Dalton SL, Roos KG, Djoko A, Phelps J, Dompier TP. Comparison of Indiana high school football injury rates by inclusion of the USA football “heads up football” player safety coach. Orthop J Sports Med. 2016;4(5):2325967116648441.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    USA Football. Heads up football. https://usafootball.com/programs/heads-up-football/. Accessed 27 Sept 2019.
  31. 31.
    Schussler E, Jagacinski RJ, White SE, Chaudhari AM, Buford JA, Onate JA. The effect of tackling training on head accelerations in youth american football. Int J Sports Phys Ther. 2018;13(2):229–37.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    ALAN SCHWARZ. N.F.L.-backed youth program says it reduced concussions. the data disagrees. https://search.proquest.com/docview/1807059662. Updated 2016.
  33. 33.
    Hallenbeck S. USA football statement on New York times article about heads up football. 2016.Google Scholar
  34. 34.
    Shanley E, Thigpen C, Kissenberth M, Gilliland RG, Thorpe J, Nance D, Register-Mihalik JK, Tokish J. Heads up football training decreases concussion rates in high school football players. Clin J Sports Med.:1.  https://doi.org/10.1097/jsm.0000000000000711.
  35. 35.
    Shewchenko N, Withnall C, Keown M, Gittens R, Dvorak J. Heading in football. Part 3: effect of ball properties on head response. Br J Sports Med. 2005;39(suppl 1):i39.Google Scholar
  36. 36.
    Caccese J, Kaminski T. Minimizing head acceleration in soccer: a review of the literature. Sports Med. 2016;46(11):1591–604.CrossRefGoogle Scholar
  37. 37.
    Anonymous. Reducing injury risk from body checking in boys’ youth ice hockey. Pediatrics. 2014;133(6):1151–7.CrossRefGoogle Scholar
  38. 38.
    Collins C, Fletcher E, Fields S, et al. Neck strength: a protective factor reducing risk for concussion in high school sports. J Prim Prev. 2014;35(5):309–19.CrossRefGoogle Scholar
  39. 39.
    Eckner JT, Goshtasbi A, Curtis K, et al. Feasibility and effect of cervical resistance training on head kinematics in youth athletes: a pilot study. Am J Phys Med Rehabil. 2018;97(4):292–7.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Tierney RT, Higgins M, Caswell SV, et al. Sex differences in head acceleration during heading while wearing soccer headgear. J Athl Train. 2008;43(6):578–84.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Benson BW, Gunter FE, Rauch R, et al. What are the most effective risk-reduction strategies in sport concussion? J Med Genet. 2013;47(5):321.Google Scholar
  42. 42.
    Tierney RT, Sitler MR, Swanik CB, Swanik KA, Higgins M, Torg J. Gender differences in head-neck segment dynamics stabilization during head acceleration. Med Sci Sports Exerc. 2005;37(2):272–9.CrossRefGoogle Scholar
  43. 43.
    Mansell J, Tierney RT, Sitler MR, Swanik KA, Stearne D. Resistance training and head-neck segment dynamic stabilization in male and female collegiate soccer players. J Athl Train. 2005;40(4):310–9.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Hildenbrand K, Vasavada A. Collegiate and high school athlete neck strength in neutral and rotated postures. J Strength Cond Res. 2013;27(11):3173–82.CrossRefGoogle Scholar
  45. 45.
    Toninato JC, Casey H, Uppal M, Abdallah T, Bergman T, Eckner JT, Samadani U. Traumatic brain injury reduction in athletes by neck strengthening (TRAIN). Contemp Clin Trials Commun. 2018;11:102–6.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Wiebe DJ, D’Alonzo BA, Harris R, Putukian M, Campbell-McGovern C. Association between the experimental kickoff rule and concussion rates in ivy league football. JAMA. 2018;320(19):2035–6.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Pop Warner. Limited contact in practice rule. https://tshq.bluesombrero.com/Default.aspx?tabid=1476228. Accessed 27 Sept 2019.
  48. 48.
    Use of the helmet – rule 12, section 2, article 8. https://nflcommunications.com/Documents/Fact%20Sheet%20-%20Use%20of%20the%20Helmet.pdf. Accessed 27 Sept 2019.
  49. 49.
    Donaldson L, Asbridge M, Cusimano MD. Bodychecking rules and concussion in elite hockey. PLoS One. 2013;8(7):e69122.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Emery C, Kang J, Shrier I, et al. Risk of injury associated with bodychecking experience among youth hockey players. CMAJ. 2011;183(11):1249–56.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    McCrory P, Meeuwisse W, Dvořák J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in berlin, october 2016. Br J Sports Med. 2017;51(11):838–47.PubMedPubMedCentralGoogle Scholar
  52. 52.
    American hockey league official rule book 2018–2019. https://theahl.com/rules. Accessed 27 Sept 2019.
  53. 53.
    OHL announces player safety initiatives and rule changes for 2016–17 season. http://ontariohockeyleague.com/article/ohl-announces-player-safety-initiatives-and-rule-changes-for-2016-17-season. Updated 2019. Accessed 4 May 2019.
  54. 54.
  55. 55.
    U.S. soccer concussion guidelines. https://www.recognizetorecover.org/head-and-brain#concussions. Accessed 27 Sept 2019.
  56. 56.
  57. 57.
    Collins CL, Fields SK, Comstock RD. When the rules of the game are broken: what proportion of high school sports-related injuries are related to illegal activity? Inj Prev. 2008;14(1):34–8.CrossRefGoogle Scholar
  58. 58.
    Junge A, Dvorak J, Graf-Baumann T, Peterson L. Football injuries during FIFA tournaments and the olympic games, 1998-2001. Am J Sports Med. 2004;32(1_suppl):80–9.CrossRefGoogle Scholar
  59. 59.
    Bjørneboe J, Bahr R, Dvorak J, Andersen TE. Lower incidence of arm-to-head contact incidents with stricter interpretation of the laws of the game in norwegian male professional football. Br J Sports Med. 2013;47(8):508–14.CrossRefGoogle Scholar
  60. 60.
    Spaude LK. Time to act: correcting the inadequacy of youth concussion legislation through a federal act. Marquette Law Rev. 2017;100(3):1093.Google Scholar
  61. 61.
    Fisher PG. Have zackery lystedt concussion laws made an impact? J Pediatr. 2019;206:2–3.CrossRefGoogle Scholar
  62. 62.
    HB 1824-2009-10. Requiring the adoption of policies for the management of concussion and head injury in youth sports. Sponsors: Rodne, Quall, Anderson, Liias, Walsh, M., Pettigrew, Priest, Simpson, Kessler, Rolfes, Johmson, Sullivan, Morrell.Google Scholar
  63. 63.
    Davies S, Coxe K, Harvey HH, Singichetti B, Guo J, Yang J. Qualitative evaluation of high school implementation strategies for youth sports concussion laws. J Athl Train. 2018;53(9):873–9.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Tarimala A, Singichetti B, Yi H, et al. Initial emergency department visit and follow-up care for concussions among children with medicaid. J Pediatr. 2019;206:178–83.CrossRefGoogle Scholar
  65. 65.
    Bompadre V, Jinguji TM, Yanez ND, et al. Washington state’s lystedt law in concussion documentation in Seattle public high schools. J Athl Train. 2014;49(4):492.CrossRefGoogle Scholar
  66. 66.
    Chrisman SP, Schiff MA, Chung SK, Herring SA, Rivara FP. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington state. Am J Sports Med. 2014;42(5):1190–6.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryRush University Medical Center, Midwest Orthopaedics at RushChicagoUSA
  2. 2.Department of PediatricsRush University Medical CenterChicagoUSA

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