Concussions among United States high school and collegiate athletes

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Gessel, Luke M.¹; Fields, Sarah K.¹; Collins, Christy L.²; Dick, Randall W.³; Comstock, R. Dawn^1,2

Concussions among United States high school and collegiate athletes

J Athl Train. October–December 2007;42(4):495-503

© National Athletic Trainers’ Association, Inc

Affiliations

¹The Ohio State University, Columbus, OH

²Nationwide Children's Hospital, Columbus, OH

³National Collegiate Athletic Association, Indianapolis, IN
Abstract and keywords

Context: An estimated 300 000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. Sports are second only to motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24 years.

Objective: To investigate the epidemiology of concussions in a nationally representative sample of high school athletes and to compare rates of concussion among high school and collegiate athletes.

Design: Descriptive epidemiologic study

Setting: 100 United States high schools and 180 US colleges. Patients or Other Participants: United States high school and collegiate athletes.

Main Outcome Measure(s): Data from 2 injury surveillance systems, High School Reporting Information Online (RIO) and the National Collegiate Athletic Association Injury Surveillance System, were analyzed to calculate rates, describe patterns, and evaluate potential risk factors for sport-related concussion.

Results: Concussions represented 8.9% (n 396) of all high school athletic injuries and 5.8% (n 482) of all collegiate athletic injuries. Among both groups, rates of concussions were highest in the sports of football and soccer. In high school sports played by both sexes, girls sustained a higher rate of concussions, and concussions represented a greater proportion of total injuries than in boys. In all sports, collegiate athletes had higher rates of concussion than high school athletes, but concussions represented a greater proportion of all injuries among high school athletes.

Conclusions: Sport-related injury surveillance systems can provide scientific data to drive targeted injury-prevention projects. Developing effective sport-related concussion preventive measures depends upon increasing our knowledge of concussion rates, patterns, and risk factors.

Keywords: epidemiology; injury surveillance; sex differences; traumatic brain injury
Links

PubMed: 18174937

PubMedCentral: PMC2140075

WoS: 000252343100009

Cited Works (10)

Year	Entry
2003	Guskiewicz KM, McCrea M, Marshall SW, Cantu RC, Randolph C, Barr W, Onate JA, Kelly JP. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA concussion study. JAMA. November 19, 2003;290(19):2549-2555.
2002	Collins MW, Lovell MR, Iverson GL, Cantu RC, Maroon JC, Field M. Cumulative effects of concussion in high school athletes. Neurosurgery. November 2002;51(5):1175-1179.
2000	Guskiewicz KM, Weaver NL, Padua DA, Garrett WE Jr. Epidemiology of concussion in collegiate and high school football players. Am J Sports Med. September 2000;28(5):643-650.
1999	Powell JW, Barber-Foss KD. Traumatic brain injury in high school athletes. JAMA. September 8, 1999;282(10):958-963.
1996	Sosin DM, Sniezek JE, Thurman DJ. Incidence of mild and moderate brain injury in the United States, 1991. Brain Inj. January 1996;10(1):47-54.
2004	McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. January 2004;14(1):13-17.
2007	Nelson AJ, Collins CL, Yard EE, Fields SK, Comstock RD. Ankle injuries among United States high school sports athletes, 2005–2006. J Athl Train. July 2007;42(3):381-387.
2007	Shankar PR, Fields SK, Collins CL, Dick RW, Comstock RD. Epidemiology of high school and collegiate football injuries in the United States, 2005-2006. Am J Sports Med. 2007;35(8):1295-1303.
2003	Field M, Collins MW, Lovell MR, Maroon J. Does age play a role in recovery from sports-related concussion? a comparison of high school and collegiate athletes. J Pediatr. May 2003;142(5):546-553.
2006	Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Clin J Sport Med. March 2006;16(2):97-106.

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Year	Entry
2016	Taylor K, Hoshizaki TB, Hoshizaki TB, Gilchrist MD. Dynamic head response and maximum principal tissue strain for helmeted (American football) and non‐helmeted impacts. In: Proceedings of the 2016 International IRCOBI Conference on the Biomechanics of Injury. September 14-16, 2016; Malaga, Spain.217-227.
2019	Shah AS, Chiariello R, Dolick K, Wild A, Nelson LD, Gibson P, Hedin DS, McCrea M, Stemper BD. Video assessment and evaluation of two wearable sensors in American football players. In: Proceedings of the 2019 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2019; Florence, Italy.612-613.
2012	Marar M, McIlvain NM, Fields SK, Comstock RD. Epidemiology of concussions among U States high school athletes in 20 sports. Am J Sports Med. April 2012;40(4):747-755.
2012	Gysland SM, Mihalik JP, Register-Mihalik JK, Trulock SC, Shields EW, Guskiewicz KM. The relationship between subconcussive impacts and concussion history on clinical measures of neurologic function in collegiate football players. Ann Biomed Eng. January 2012;40(1):14-22.
2012	Broglio SP, Surma T, Ashton-Miller JA. High school and collegiate football athlete concussions: a biomechanical review. Ann Biomed Eng. January 2012;40(1):37-46.
2012	Ocwieja KE, Mihalik JP, Marshall SW, Schmidt JD, Trulock SC, Guskiewicz KM. The effect of play type and collision closing distance on head impact biomechanics. Ann Biomed Eng. January 2012;40(1):90-96.
2012	Castile L, Collins CL, McIlvain NM, Comstock RD. The epidemiology of new versus recurrent sports concussions among high school athletes, 2005–2010. Br J Sports Med. 2012;46(8):603-610.
2013	McCrory P, Meeuwisse WH, Aubry M, Cantu B, Dvořák J, Echemendia RJ, Engebretsen L, Johnston K, Kutcher JS, Raftery M, Sills A, Benson BW, Davis GA, Ellenbogen RG, Guskiewicz K, Herring SA, Iverson GL, Jordan BD, Kissick J, McCrea M, McIntosh AS, Maddocks D, Makdissi M, Purcell L, Putukian M, Schneider K, Tator CH, Turner M. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med. April 2013;47(5):250-258.
2011	Daneshvar DH, Nowinski CJ, McKee AC, Cantu RC. The epidemiology of sport-related concussion. Clin Sports Med. January 2011;30(1):1-17.
2021	DiGuglielmo DM, Kelley ME, Espeland MA, Gregory ZA, Payne TD, Jones DA, Filben TM, Powers AK, Stitzel JD, Urban JE. The effect of player contact characteristics on head impact exposure in youth football games. J Appl Biomech. 2021;37(2):145-155.
2012	Breedlove EL, Robinson M, Talavage TM, Morigaki KE, Yoruk U, O'Keefe K, King J, Leverenz LJ, Gilger JW, Nauman EA. Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football J Biomech. April 30, 2012;45(7):1265-1272.
2012	Brainard L, Beckwith J, Chu J, Crisco J, Mcallister T, Duhaime A-C, Maerlender A, Greenwald R. Gender differences in head impacts sustained by collegiate ice hockey players. Med Sci Sports Exer. February 2012;44(2):297-304.
2018	Sollmann N, Echlin PS, Schultz V, Viher PV, Lyall AE, Tripodis Y, Kaufmann D, Hartl E, Kinzel P, Forwell LA, Johnson AM, Skopelja EN, Lepage C, Bouix S, Pasternak O, Lin AP, Shenton ME, Koerte IK. Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players. NeuroImage Clin. 2018;17:642-649.
2019	Jastifer JR, McNitt AS, Mack CD, Kent RW, McCullough KA, Coughlin MJ, Anderson RB. Synthetic turf: history, design, maintenance, and athlete safety. Sports Health. January–February 2019;11(1):84-90.
2020	Hanna B. Development of a Metamaterial for Use in American Football Head Protection [PhD thesis]. Cardiff University; September 2020.
2017	Aggelou AE. Concussion as a Risk Factor for Lower Extremity Musculoskeletal Injury in Collegiate Athletes [PhD thesis]. University of Pittsburgh; 2017.
2020	Fanton M. Effect of Cervical Spine and Helmet Properties on Traumatic Brain Injury [PhD thesis]. Stanford University; July 2020.
2013	Brown HJ. Development and Validation of an Objective Balance Error Scoring System [Master's thesis]. Vancouver, BC: University of British Columbia; September 2013.
2017	Stuart CA. Snow Sport Head Injury: Characterization of Clinical Presentation and Design of a Relevant Head Impact Apparatus [Master's thesis]. Vancouver, BC: University of British Columbia; April 2017.
2021	Wahlquist VE. Purposeful Soccer Heading Exposure and Clinical Outcomes in Youth Soccer Players [PhD thesis]. University of Delaware; 2021.
2014	Patton DA. The Biomechanical Determinants of Sports-Related Concussion: Finite Element Simulations of Unhelmeted Head Impacts to Evaluate Kinematic and Tissue-Level Predictors of Injury and Investigate the Design Implications for Soft-Shell Headgear [PhD thesis]. University of New South Wales; March 2014.
2012	Oeur A. An Analysis of Head Impact Angle on the Dynamic Response of a Hybrid III Headform and Brain Tissue Deformation [Master's thesis]. Ottawa, ON: University of Ottawa; December 2012.
2014	Rousseau P. Analysis of Concussion Metrics of Real-World Concussive and Non-Injurious Elbow and Shoulder to Head Collisions in Ice Hockey [PhD thesis]. Ottawa, ON: University of Ottawa; 2014.
2018	Oeur RA. The Effects of Reconstructed Head Impact Event Parameters on Risk of Sport Related Concussions [PhD thesis]. Ottawa, ON: University of Ottawa; 2018.
2018	Taylor K. The Use of Decoupling Structures in Helmet Liners to Reduce Maximum Principal Brain Tissue Strain for Head Impacts [PhD thesis]. University of Ottawa; 2018.
2019	Karton C. Profiling Brain Trauma in Professional American-Style Football and the Implications to Developing Neurological Injury [PhD thesis]. Ottawa, ON: University of Ottawa; 2019.
2013	Young TJ. Head Impact Biomechanics and Helmet Performance in Youth Football [Master's thesis]. Virginia Polytechnic Institute and State University; December 9, 2013.
2014	Daniel RW II. Evaluation of Football Safety Techniques Utilizing Biomechanical Measurements [PhD thesis]. Virginia Polytechnic Institute and State University; June 3, 2014.
2017	Campolettano ET. On-Field Measurement of Head Impacts in Youth Football: Characterizing High Magnitude Impacts and Assessing Balance Outcomes [Master's thesis]. Virginia Polytechnic Institute and State University; March 30, 2017.
2021	Kieffer EE. Sex-Specific Head Impact Exposure in Rugby: Measurement Considerations and Relationships to Clinical Outcomes [PhD thesis]. Virginia Polytechnic Institute and State University; March 18, 2021.
2014	Campbell K. Quantifying and Comparing the Head Impact Biomechanics of Different Player Positions for Canadian University Football [Master's thesis]. University of Western Ontario; 2014.
2016	Brooks JS. The Use of P3b as an Indicator of Neurophysiologic Change from Subconcussive Impacts in Football Players [Master's thesis]. University of Western Ontario; 2016.
2020	Harriss A. Cumulative Purposeful Soccer Heading Can Lead to Compensatory Changes in Brain Activity During Combined Moderate Exercise and Cognitive Load in Female Youth Soccer Players [PhD thesis]. University of Western Ontario; 2020.
2015	Urban JE. Real-World and Population-Based Studies of Head Injury Causation [PhD thesis]. Winston-Salem, NC: Wake Forest University; May 2015.