Concussion incidence and time-loss in Australian football: A systematic review

McNeel, Claire; Clark, Gillian M.; Davies, Charlotte B.; Major, Brendan

doi:10.1016/j.jsams.2019.10.010

Cited by 16 publications

(11 citation statements)

References 42 publications

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“…Incidence and prevalence of concussion in football have been reported and studied extensively at the youth, 6,33 middle school, 2 high school, 22,30,35-37,41 and collegiate levels. 17,18,34,42 In professional sports, epidemiologic studies of concussion have been reported in Major League Baseball, 7,38 the National Basketball Association, 31 the National Hockey League, 5 Australian Rules Football, 9,27 and globally across soccer 3,10 and rugby. 11…”

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confidence: 99%

Epidemiology of Concussion in the National Football League, 2015-2019

Mack

Solomon

Covassin

et al. 2021

Sports Health: A Multidisciplinary Approach

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Background: Concussion in American football, and specifically the National Football League (NFL) is a major area of interest and key focus for injury prevention. Complete and accurate characterization of when, how, and to whom these injuries occur can facilitate injury reduction efforts. Existing studies of concussion in the NFL use publicly available data, potentially limiting data quality and the inferences that can be made. Hypothesis: Concussion incidence in the NFL decreased across the 2015-2019 seasons. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Concussion incidence, including counts, one-season risk, and rates per game and player-plays, among active NFL players from 2015 to 2019 is described by year, season, play type, and roster position. Results: A total 1302 concussions were identified from 2015 to 2019 among 1004 players. Of these, 80% occurred in NFL games. The average annual incidence of in-season game concussions changed over the study period, from 230.7 per season (2015-2017) to 177.0 per season (2018-2019); this represented a 23% decrease in game settings ( P < 0.01). Practice concussions fluctuated across the years of the study from 38 to 67 per season (average = 50.8/season). There were 70.6 concussions per 100 preseason games, which was slightly higher than the regular season rate per game of 61.7. Overall, there were 790 regular season game concussions across 4,657,243 player-plays and 114,428 player-games during the 5-year study. In regular season games, the majority of concussions were sustained on running and passing plays (n = 119/season), and the highest average rate per play occurred on kickoffs (0.69/100 plays). Defensive secondary (cornerbacks, safeties, and generic defensive backs) and offensive line incurred the most concussions, and the highest rates of concussion were among tight ends and wide receivers. Conclusion and Relevance: Concussions in the NFL are a key focus for player safety. Concussion reduction strategies were implemented before 2018, after which there was a sustained 2-year decrease in concussion incidence, providing a new benchmark from which to work toward further injury reduction.

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confidence: 99%

Epidemiology of Concussion in the National Football League, 2015-2019

Mack

Solomon

Covassin

et al. 2021

Sports Health: A Multidisciplinary Approach

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“…The incidence of concussion among Australian football players has also been presented 2. This systematic review provides useful epidemiological information and a clear justification for why meta-analysis was not conducted.…”

Section: Imprecision In Gradementioning

confidence: 99%

“…Epidemiological systematic reviews are increasing in the field of sport and exercise medicine (SEM). For example, the prevalence or incidence rates of lower extremity (eg, knee), upper extremity (eg, hands), and head and neck injuries have been synthetised in different types of sports (eg, basketball) 1–4. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system is a rigorous and transparent approach that allows researchers to rate the certainty of evidence based on analysis of the risk of bias, inconsistency, indirectness, imprecision and publication bias 5.…”

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confidence: 99%

GRADE system in systematic reviews of prevalence or incidence studies evaluating sport-related injuries: why is GRADE important?

Martínez-Calderon,

García-Muñoz

2024

Br J Sports Med

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“…Male participants (n = 38) were recruited from professional Australian Football League (AFL) teams in Australia between 2014 and 2019. AFL is a sport played at speed and with a high incidence of concussion, of up to 17.6 concussions per 1000 player hours [39][40][41] . All participants were recruited after having suffered a suspected mTBI (concussion).…”

Section: Participantsmentioning

confidence: 99%

White matter abnormalities characterise the acute stage of sports-related mild Traumatic Brain Injury

Mito

Parker

Abbott

et al. 2022

Preprint

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Sports-related concussion, a form of mild traumatic brain injury (mTBI), is characterised by transient disturbances of brain function. There is increasing evidence that functional brain changes are driven by subtle abnormalities in white matter microstructure, and diffusion MRI has been instrumental in demonstrating these white matter abnormalities in vivo. However, the reported location and direction of the observed white matter changes in mTBI are quite variable, which is likely attributable to the inherent limitations of the white matter models used. In this cross-sectional study, we apply an advanced and robust technique known as fixel-based analysis to investigate fibre tract-specific abnormalities in professional Australian Football League players with a recent mTBI. We used the fixel-based analysis framework to identify common abnormalities found in specific fibre tracts in participants with an acute mTBI (< 2 weeks after injury; n = 15). We then assessed whether similar changes exist in subacute mTBI (> 2 weeks and < 3 months after injury; n = 15). The control group was 30 neurologically healthy control participants. We assessed microstructural differences in fibre density and fibre bundle morphology and performed whole-brain fixel-based analysis to compare groups. Subsequent tract-of-interest analyses were performed within five selected white matter tracts, to investigate the relationship between the observed tract-specific abnormalities and days since injury, as well as the relationship between these tract-specific changes with cognitive abnormalities. Our whole-brain analyses revealed significant increases in fibre density and bundle cross-section in acute mTBI when compared to controls. Acute mTBI showed even more extensive differences when compared to subacute mTBI than to controls. The fibre structures affected in acute mTBI included the corpus callosum, left prefrontal and left parahippocampal white matter. The fibre density and cross-sectional increases were independent of time since injury in acute mTBI, and were not associated with cognitive deficits. Overall, this study demonstrates that acute mTBI is characterised by specific white matter abnormalities, which are compatible with tract-specific cytotoxic oedema. These oedematous changes were absent in our subacute mTBI participants, although subtle abnormalities may persist in the subacute stage.

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Concussion incidence and time-loss in Australian football: A systematic review

Cited by 16 publications

References 42 publications

Epidemiology of Concussion in the National Football League, 2015-2019

Epidemiology of Concussion in the National Football League, 2015-2019

GRADE system in systematic reviews of prevalence or incidence studies evaluating sport-related injuries: why is GRADE important?

White matter abnormalities characterise the acute stage of sports-related mild Traumatic Brain Injury

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