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J Neurotrauma. 2016 Jan 15;33(2):254-9. doi: 10.1089/neu.2015.3930. Epub 2015 Jul 20.

Division III Collision Sports Are Not Associated with Neurobehavioral Quality of Life.

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1 Micheli Center for Sports Injury Prevention , Waltham, Massachusetts.
2 Brain Injury Center, Boston Children's Hospital , Boston, Massachusetts.
3 Sports Concussion Clinic, Boston Children's Hospital , Boston, Massachusetts.
4 Division of Emergency Medicine, Boston Children's Hospital , Boston, Massachusetts.
5 Department of Neurology, Boston Children's Hospital , Boston, Massachusetts.
6 Health Services, Colby College , Waterville, Maine.
7 Department of Psychology, Williams College , Williamstown, Massachusetts.
8 Middlebury College , Middlebury, Vermont.
9 Department of Psychology, Wesleyan University , Middletown, Connecticut.
10 Department of Neurology, Beth Israel Deaconess Medical Center , Boston, Massachusetts.


We sought to determine whether the exposure to the sub-concussive blows that occur during division III collegiate collision sports affect later life neurobehavioral quality-of-life measures. We conducted a cross-sectional study of alumni from four division III colleges, targeting those between the ages of 40-70 years, using several well-validated quality-of-life measures for executive function, general concerns, anxiety, depression, emotional and behavior dyscontrol, fatigue, positive affect, sleep disturbance, and negative consequences of alcohol use. We used multivariable linear regression to assess for associations between collision sport participation and quality-of-life measures while adjusting for covariates including age, gender, race, annual income, highest educational degree, college grades, exercise frequency, and common medical conditions. We obtained data from 3702 alumni, more than half of whom (2132) had participated in collegiate sports, 23% in collision sports, 23% in non-contact sports. Respondents with a history of concussion had worse self-reported health on several measures. When subjects with a history of concussion were removed from the analyses in order to assess for any potential effect of sub-concussive blows alone, negative consequences of alcohol use remained higher among collision sport athletes (β-coefficient 1.957, 95% CI 0.827-3.086). There were, however, no other significant associations between exposure to collision sports during college and any other quality-of-life measures. Our results suggest that, in the absence of a history of concussions, participation in collision sports at the Division III collegiate level is not a risk factor for worse long-term neurobehavioral outcomes, despite exposure to repeated sub-concussive blows.


athletics; chronic traumatic encephalopathy; concussions; head injury

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