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Abstract
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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.
OBJECTIVE: Estimate rates of SRC in MHSAA football programs and evaluate progressive limitations to collision practices over five consecutive seasons.
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.
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.
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.
Language: en |