Format

Send to

Choose Destination
Br J Sports Med. 2017 Jun;51(12):978-984. doi: 10.1136/bjsports-2016-097452. Epub 2017 Mar 2.

What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review.

Author information

1
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
2
Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway.
3
Oslo Sports Trauma Research Center, Oslo, Norway.
4
Medical and Scientific Department, International Olympic Committee (IOC), Lausanne, Switzerland.
5
Division of Neurosurgery, University of Toronto, Ontario, Canada.
6
Concussion Management Program Athletic Edge Sports Medicine, Ontario, Canada.
7
Carleton University Sport Medicine Centre, Ontario, Canada.
8
Department of Family Medicine, University of Ottawa, Ontario, Canada.
9
International Paralympic Committee Medical Committee.
10
Perry Maddocks Trollope Lawyers.
11
Canadian Concussion Centre, Toronto Western Hospital, University Health Network, Ontario, Canada.
12
Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada.
13
Ottawa Sport Medicine Centre, Ontario, Canada.
14
International Ice Hockey Federation.
15
IOC Medical Commission Games Group.
16
Department of Neurology, University of Zurich, Zurich, Switzerland.
17
Schulthess Clinic Zurich.
18
Department of Neurosurgery, Tokushima University Hospital, Tokushima, Japan.

Abstract

AIM OR OBJECTIVE:

To examine the effectiveness of concussion prevention strategies in reducing concussion risk in sport.

DESIGN:

Systematic review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines.

DATA SOURCES:

Eleven electronic databases searched and hand-search of references from selected studies.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES:

The following were the study inclusion criteria: (1) contained original human research data; (2) investigated an outcome of concussion or head impact; (3) evaluated a concussion prevention intervention; (4) included sport participants; (5) analytical study designand (6) peer-reviewed. The following were the exclusion criteria: (1) review articles, case series or case studies and (2) not in English.

RESULTS:

The studies selected (n=48) provided evidence related to protective gear (helmets, headgear, mouthguards) (n=25), policy and rule changes (n=13) and other interventions (training, education, facilities) (n=10). Meta-analyses demonstrate a combined effect of a 70% reduction (incidence rate ratio (IRR)=0.3 (95% CI: 0.22 to 0.41)) in concussion risk in youth ice hockey leagues where policy disallows body checking, and the point estimate (IRR=0.8 (95% CI: 0.6 to 1.1)) suggests a protective effect of mouthguards in contact and collision sport (basketball, ice hockey, rugby).

SUMMARY/CONCLUSIONS:

Highlights include a protective effect of helmets in skiing/snowboarding and the effectiveness of policy eliminating body checking in youth ice hockey. Future research should examine mouthguards in contact sport, football helmet padding, helmet fit in collision sport, policy limiting contact practice in youth football, rule enforcement to reduce head contact in ice hockey and soccer, ice surface size and board/glass flexibility in ice hockey and training strategies targeting intrinsic risk factors (eg, visual training).

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO 2016:CRD42016039162.

KEYWORDS:

concussion; prevention; sport Injury

PMID:
28254746
DOI:
10.1136/bjsports-2016-097452
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center