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Journal Article

Citation

Greenhill DA, Navo P, Zhao H, Torg J, Comstock RD, Boden BP. Sports Health 2016; 8(3): 238-243.

Affiliation

The Orthopaedic Center, Rockville, Maryland.

Copyright

(Copyright © 2016, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/1941738116639027

PMID

27005467

Abstract

BACKGROUND: There is limited information on the relationship between American football helmet fit and concussion severity. HYPOTHESIS: Poor helmet fit may predispose football players to a more severe concussion. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3.

METHODS: Data from concussion injury reports were obtained from the National High School Sports-Related Injury Surveillance System over a 9-year period. Symptoms, duration, and helmet parameters (fit, interior padding) were analyzed for all first-time concussions.

RESULTS: Data from 4580 concussions were analyzed. Patients who suffered concussions with a helmet that did not fit properly (3.22%), as determined by an athletic trainer, had higher rates of drowsiness (RR, 1.46; P = 0.005), hyperexcitability (RR, 2.38; P = 0.047), and sensitivity to noise (RR, 1.88; P < 0.001); had more symptoms (5.34 vs 4.54, P = 0.004); and had longer symptom duration (P = 0.04). Athletes with helmets lined with an air bladder had greater rates of sensitivity to light (RR, 1.13; P = 0.02), sensitivity to noise (RR, 1.25; P = 0.009), and longer symptom duration (P = 0.004) compared with foam or gel liners.

CONCLUSION: An improperly fitted football helmet is a risk factor for a concussion with more symptoms and of longer duration. Concussions of longer duration are also more common in players with an air bladder-lined helmet. Current high school football rules should mandate supervision and maintenance of helmet fit throughout the season, prior to impact. CLINICAL RELEVANCE: Team physicians, athletic trainers, coaches, and high school officials should ensure proper oversight of helmet fit in high school athletes to decrease concussion severity and duration.

© 2016 The Author(s).


Language: en

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