Age of First Exposure to Collision Sports Does Not Affect Patient Reported Outcomes in Women and Men Community Rugby Players

Hunzinger, Katherine J.; Caccese, Jaclyn B.; Costantini, Katelyn; Swanik, C. Buz; Buckley, Thomas A.

doi:10.1249/mss.0000000000002657

Cited by 12 publications

(7 citation statements)

References 58 publications

(142 reference statements)

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“…Hunzinger et al ( 121 ) surveyed 1,034 current and former community-level rugby players. Participants completed patient-reported outcomes, including the Brief Symptom Inventory 18 to assess psychological distress, the Short Form Health Survey 12 to assess physical and mental health quality of life, and the Satisfaction with Life Scale.…”

Section: Studies With Retired Amateur and Professional Athletesmentioning

confidence: 99%

Age of First Exposure to Contact and Collision Sports and Later in Life Brain Health: A Narrative Review

Büttner

Caccese

2021

Front. Neurol.

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A controversial theory proposes that playing tackle football before the age of 12 causes later in life brain health problems. This theory arose from a small study of 42 retired National Football League (NFL) players, which reported that those who started playing tackle football at a younger age performed worse on selected neuropsychological tests and a word reading test. The authors concluded that these differences were likely due to greater exposure to repetitive neurotrauma during a developmentally sensitive maturational period in their lives. Several subsequent studies of current high school and collegiate contact/collision sports athletes, and former high school, collegiate, and professional tackle football players have not replicated these findings. This narrative review aims to (i) discuss the fundamental concepts, issues, and controversies surrounding existing research on age of first exposure (AFE) to contact/collision sport, and (ii) provide a balanced interpretation, including risk of bias assessment findings, of this body of evidence. Among 21 studies, 11 studies examined former athletes, 8 studies examined current athletes, and 2 studies examined both former and current athletes. Although the literature on whether younger AFE to tackle football is associated with later in life cognitive, neurobehavioral, or mental health problems in former NFL players is mixed, the largest study of retired NFL players (N = 3,506) suggested there was not a significant association between earlier AFE to organized tackle football and worse subjectively experienced cognitive functioning, depression, or anxiety. Furthermore, no published studies of current athletes show a significant association between playing tackle football (or other contact/collision sports) before the age of 12 and cognitive, neurobehavioral, or mental health problems. It is important to note that all studies were judged to be at high overall risk of bias, indicating that more methodologically rigorous research is needed to understand whether there is an association between AFE to contact/collision sports and later in life brain health. The accumulated research to date suggests that earlier AFE to contact/collision sports is not associated with worse cognitive functioning or mental health in (i) current high school athletes, (ii) current collegiate athletes, or (iii) middle-aged men who played high school football. The literature on former NFL players is mixed and does not, at present, clearly support the theory that exposure to tackle football before age 12 is associated with later in life cognitive impairment or mental health problems.

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Section: Studies With Retired Amateur and Professional Athletesmentioning

confidence: 99%

Age of First Exposure to Contact and Collision Sports and Later in Life Brain Health: A Narrative Review

Büttner

Caccese

2021

Front. Neurol.

Self Cite

View full text Add to dashboard Cite

show abstract

“… 19 Similarly, recent investigations of middle-aged former American football players and American amateur rugby players (male and female) reported that career duration was unrelated to later-life or mid-life health conditions and dysfunction. 11 , 39 , 41 Taken together, data among physically active early- to mid-adult collision sport athletes (i.e., aged 22–50 years) suggest that RHI exposure does not adversely affect objective measures of neurobehavioral health; 3 however, the later-life effects (i.e., older adults aged >65 years) and the effects in physically inactive individuals with histories of prolonged RHI exposure (e.g., former adult rugby players who are inactive) remain unknown.…”

Section: Discussionmentioning

confidence: 99%

“…However, this method was chosen based on the recommendation of the NINDS traumatic encephalopathy syndrome consensus statement and has been previously utilized in other research as a measure of RHI exposure because it permits a rough estimation in the absence of biomechanical data, which is not feasible to collect across the lifespan. 3 , 7 , 11 Lastly, this study relied on self-reported measures of physical activity as a dichotomous outcome (yes/no for meeting American College of Sports Medicine physical activity guidelines). Although self-reported measures of physical activity have been used in previous research, 54 they may fail to capture the accuracy and precision needed to detect the true effects of exercise (i.e., frequency, intensity, type, time) on the included outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with previous studies, contact/collision sports included those with potential and/or routine RHI exposure (i.e., American football, soccer, ice hockey, boxing, rugby, lacrosse, and wrestling). 2 , 11 Briefly, participants were recruited from 4 groups: (a) NON: individuals with no previous contact/collision sport experience who are not currently physically active ( n = 28); (b) NCA: non-contact/collision sport athletes/individuals with no previous contact/collision sport experience who are physically active ( n = 29); (c) HRS: former contact/collision sport athletes who are physically active ( n = 29); and (d) RUG: current/former rugby players with a history of playing rugby after age 22 who are physically active ( n = 27). Of note, none of the RUG group participants had actively participated in contact rugby in the 6 months prior to the study due to coronavirus disease 2019 (COVID-19) related shutdowns (years since last participating in contact/collision rugby: 8.5 ± 9.8 years; range: 0.5–36 years).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, they continue to experience RHI through adulthood and often exceed the traumatic encephalopathy syndrome threshold for exposure. 7 , 11 , 12 Growing evidence links rugby participation and long-term physical and mental health dysfunction; however, sports participation during adulthood is associated with increased physical activity, a known positive modifier of long-term health outcomes. 13 , 14 , 15 , 16 Thus, the negative effects of RHI and the positive effects of physical activity on mid- and later-life neurobehavioral health (e.g., gait) remain to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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