@article{ref1,
title="Avenues for sport-related concussion prevention in high school football: impact of limiting collision practices",
journal="Journal of athletic training",
year="2022",
author="Bretzin, Abigail C. and Tomczyk, Christopher P. and Wiebe, Douglas J. and Covassin, Tracey",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="CONTEXT: Football continues to report the highest rate of sport-related concussions (SRC) in high school athletics. To mitigate SRC risk the Michigan High School Athletic Association (MHSAA) implemented rules aimed at reducing the number of collisions occurring in practices. <br><br>OBJECTIVE: Estimate rates of SRC in MHSAA football programs and evaluate progressive limitations to collision practices over five consecutive seasons. <br><br>DESIGN: Cohort Study. SETTING: Michigan high school football. PATIENTS OR OTHER PARTICIPANTS: High school (9th-12th grade) football athletes (over 99% male) participating in MHSAA athletic-sanctioned events. MAIN OUTCOME MEASURES: Designated administrators at each school record the total number of participating athletes and SRCs into the MHSAA injury surveillance system, head injuries resulted from athletic participation required the student-athlete to be withheld from activity after exhibiting signs, symptoms, or behaviors consistent with a SRC, each season (2015-16 through 2019-20). Progressive limitations to collision practices occurred across the study period. We estimated athlete-exposures (AE) as the total number of players multiplied by the total number of possible practices (11 weeks, 4 days each) or competitions (9 weeks, 1 day each) during each season. Incidence rates and rate ratios (RR) with 95% confidence intervals (CI) compared practice and competition SRC and each season relative to the most recent season. <br><br>RESULTS: There were a total of 7,755 diagnosed football SRCs across the five-year period. The overall SRC rate was 8.03 per 10,000 AE (95% CI:7.85,8.21). The competition SRC rate (30.13/10,000 AE) was higher than practice (3.51/10,000 AE; RR:8.58, 95% CI:8.19,9.00). The practice SRC rate was lower in 2017-18 (RR: 0.86,95% CI: 0.77,0.97), 2018-19 (RR: 0.89, 95% CI: 0.79,1.0), and 2019-20 (RR: 0.83, 95% CI: 0.74,0.94) relative to 2015-16. <br><br>CONCLUSIONS: We found that the progressive limitations to collision practices were protective against SRC, as the rate of SRC was lower in the three most recent seasons relative to 2015-16.<p /> <p>Language: en</p>",
language="en",
issn="1062-6050",
doi="10.4085/1062-6050-0341.21",
url="http://dx.doi.org/10.4085/1062-6050-0341.21"
}