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

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

  • Emery CA Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
  • Black AM Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
  • Kolstad A Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
  • Martinez G Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
  • Nettel-Aguirre A Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
  • Engebretsen L Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway.
  • Johnston K Division of Neurosurgery, University of Toronto, Ontario, Canada.
  • Kissick J Carleton University Sport Medicine Centre, Ontario, Canada.
  • Maddocks D Perry Maddocks Trollope Lawyers.
  • Tator C Canadian Concussion Centre, Toronto Western Hospital, University Health Network, Ontario, Canada.
  • Aubry M Ottawa Sport Medicine Centre, Ontario, Canada.
  • Dvořák J Department of Neurology, University of Zurich, Zurich, Switzerland.
  • Nagahiro S Department of Neurosurgery, Tokushima University Hospital, Tokushima, Japan.
  • Schneider K Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Alberta, Canada.
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  • 2017-03-04
Published in:
  • British journal of sports medicine. - 2017
English 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/47491
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