Prevention of concussions

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Demonstration in 1912 of the Warren Safety Helmet, which was designed to protect pilots but has often been wrongly thought to be a football helmet. 1912 Warren Safety Helmet.jpg
Demonstration in 1912 of the Warren Safety Helmet, which was designed to protect pilots but has often been wrongly thought to be a football helmet.

Prevention of mild traumatic brain injury involves taking general measures to prevent traumatic brain injury, such as wearing seat belts, using airbags in cars, securing heavy furnitures and objects before earthquake or covering and holding under the table during an earthquake. [2] [3] Older people are encouraged to try to prevent falls, for example by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance. [4]

Unfortunately, to date, there is no data to support the claim that any particular type of helmet or protective equipment reduces the risk of sports-related concussion. [5] Improvements in the design of protective athletic gear such as helmets may decrease the number and severity of such injuries. [6] New "Head Impact Telemetry System" technology is being placed in helmets to study injury mechanisms and potentially help reduce the risk of concussions among American Football players. Changes to the rules or the practices of enforcing existing rules in sports, such as those against "head-down tackling", or "spearing", which is associated with a high injury rate, may also prevent concussions. [5]

In sports

Prevention of undiagnosed and repeat injury is of importance in sports-related concussions. [7] Every three minutes, a child in the United States is treated for a sports-related concussion. [8] Between 2010 and 2014, sports-related concussions experienced a 500% uptick. [9] Rapid sideline testing using short neuropsychological tests that assess attention and memory function have been proven useful and accurate. The Maddocks questions [10] [11] and the Standardized Assessment of Concussion (SAC) [12] [13] [14] are examples of validated sideline evaluation tools. The Return To Play (RTP) protocol aims to decrease repeat concussions within a short time frame to minimize second impact syndrome. [7] It assures players who experience a concussion have complete cognitive and clinical recovery before returning to play. [7] Best practices of RTP involve graduated activity intensification with each step taking at least 24 hours to assure full rehabilitation within one week (includes asymptomatic at rest and during exercise). [7] In cases in which resources (i.e. neuropsychologists, neuroimaging) are available on-site, RTP may be more rapid. [7] Baseline assessments, performed before concussion occurs, provide a comparison from which to measure severity of post-concussive symptoms. However, they have not been shown to decrease risk of injury. [15] The U.S. based nonprofit National Safety Council included state-by-state concussion prevention efforts for youth-sports related concussions in its 2017 State of Safety report. [16]

Unfortunately, to date, there is no data to support the claim that any particular type of helmet or protective equipment reduces the risk of sports-related concussion. [5] Improvements in the design of protective athletic gear such as helmets may decrease the number and severity of such injuries. [17] New "Head Impact Telemetry System" technology is being placed in helmets to study injury mechanisms and potentially help reduce the risk of concussions among American Football players. Wearing a helmet is associated with a decreased risk of head injury for skiers and snowboarders. [18]

Because of the lack of data to support the use of specially constructed helmets, some companies are creating in-built helmet sensors and software for brain injury prevention. The Swiss National Ice Hockey League is testing out systems that combine helmet-integrated sensors and analysis software to reveal a player’s ongoing brain injury risk during a game. [19] The company building the technology was spun out of the Swiss Federal Institute of Technology in Lausanne, Switzerland. [20]

Changes to the rules or the practices of enforcing existing rules in sports, such as those against "head-down tackling", or "spearing", which is associated with a high injury rate, may also prevent concussions. [5] The National Football League (NFL) implemented the sideline concussion assessment protocol in 2011 which oversees the treatment of any possible concussions and ensures that the medical staff on each sideline are following proper league protocol and testing for any head trauma. [21] In 2011 the NFL enforced a kickoff rule change which moved football kickoffs five yards forward, resulting in reduced concussion incidence by 50%. [22] Rules aimed at promoting fair play, while minimizing outwardly aggressive behavior, should be encouraged in all sports. [7]

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Related Research Articles

<span class="mw-page-title-main">Concussion</span> Type of traumatic brain injury

A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.

Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur annually in the United States. Brain injuries such as closed-head injuries may result in lifelong physical, cognitive, or psychological impairment and, thus, are of utmost concern with regards to public health.

A football helmet is a type of protective headgear used mainly in gridiron football, although a structural variation has occasional use in Australian rules football. It consists of a hard plastic shell with thick padding on the inside, a face mask made of one or more plastic-coated metal bars, and a chinstrap. Each position has a different type of face mask to balance protection and visibility, and some players add polycarbonate visors to their helmets, which are used to protect their eyes from glare and impacts. Helmets are a requirement at all levels of organized football, except for non-tackle variations such as flag football. Although they are protective, players can and do still suffer head injuries such as concussions.

<span class="mw-page-title-main">Health issues in American football</span> Dangers to the health of athletes participating in American football

Health issues in American football comprise a large number of health risks associated with participating in the sport. Injuries are relatively common in American football, due to its nature as a full-contact game. Injuries occur during both practice and games. Several factors can affect the frequency of injuries: epidemiological studies have shown older players can be at a greater risk, while equipment and experienced coaches can reduce the risk of injury. Common injuries include strains, sprains, fractures, dislocations, and concussions. Concussions have become a concern, as they increase the risk of mental illnesses like dementia and chronic traumatic encephalopathy (CTE). In individual leagues like the National Football League (NFL) and National Collegiate Athletic Association (NCAA), a public injury report is published containing all injured players on a team, their injury and the game-day status of each player.

<span class="mw-page-title-main">Contact sport</span> Sport involving physical contact between players

A contact sport is any sport where physical contact between competitors, or their environment, is an integral part of the game. Contact may come about as the result of intentional or incidental actions by the players in the course of play. This is in contrast to noncontact sports where players often have no opportunity to make contact with each other and the laws of the game may expressly forbid contact. In contact sports some forms of contact are encouraged as a critical aspect of the game such as tackling, while others are incidental such as when shielding the ball or contesting an aerial challenge. As the types of contact between players is not equal between all sports they define the types of contact that is deemed acceptable and fall within the laws of the game, while outlawing other types of physical contact that might be considered expressly dangerous or risky such as a high tackle or spear tackle, or against the spirit of the game such as striking below the belt or other unsportsmanlike conduct. Where there is a limit as to how much contact is acceptable most sports have a mechanism to call a foul by the referee, umpire or similar official when an offence is deemed to have occurred.

<span class="mw-page-title-main">Chronic traumatic encephalopathy</span> Neurodegenerative disease caused by head injury

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.

<span class="mw-page-title-main">High school football</span> Secondary school competition in gridiron football

High school football is gridiron football played by high school teams in the United States and Canada. It ranks among the most popular interscholastic sports in both countries, but its popularity is declining, partly due to risk of injury, particularly concussions. According to The Washington Post, between 2009 and 2019, participation in high school football declined by 9.1%. It is the basic level or step of tackle football.

Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person has a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days, or weeks after an initial concussion, and even the mildest grade of concussion can lead to second impact syndrome. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain's arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.

Riddell Sports Group is an American company specializing in sports equipment for American football. It was headquartered in Rosemont, Illinois. In 2017, the company relocated to a new facility in adjacent Des Plaines, Illinois.

The fencing response is an unnatural position of the arms following a concussion. Immediately after moderate forces have been applied to the brainstem, the forearms are held flexed or extended for a period lasting up to several seconds after the impact. The fencing response is often observed during athletic competition involving contact, such as combat sports, American football, Ice hockey, rugby union, rugby league and Australian rules football. It is used as an overt indicator of injury force magnitude and midbrain localization to aid in injury identification and classification for events including on-field and/or bystander observations of sports-related head injuries.

<span class="mw-page-title-main">Health issues in youth sports</span>

The health issues of youth sports are concerns regarding the health and wellbeing of young people between the ages of 6 and 18 who participate in an organized sport. Given that these athletes are physically and mentally underdeveloped, they are particularly susceptible to heat illness, eating disorders and injury; sufficiently severe conditions can result in death. Awareness and prevention are key factors in preventing many health issues in youth sports.

<span class="mw-page-title-main">Helmet-to-helmet collision</span> Dangerous contact in gridiron football

Helmet-to-helmet collisions are occurrences in gridiron football when two players' football helmets make head-to-head contact with a high degree of force. Intentionally causing a helmet-to-helmet collision is a penalty in most football leagues, including many high school leagues.

Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.

<span class="mw-page-title-main">Schutt Sports</span> Former American Manufacturer

Schutt Sports was a United States company that manufactured protective gear for several sports, focusing on American football, baseball, softball, and lacrosse. Products manufactured by company, headquartered in Litchfield, Illinois, included helmets and other protections such as jockstraps, and shoulder pads. The company also produced American football sportswear including jerseys and pants.

Concussions, a type of mild traumatic brain injury, are a frequent concern for those playing sports, from children and teenagers to professional athletes. Repeated concussions are known to cause neurological disorders, particularly chronic traumatic encephalopathy (CTE), which in professional athletes has led to premature retirement, erratic behavior and even suicide. A sports-related concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". Because concussions cannot be seen on X-rays or CT scans, attempts to prevent concussions have been difficult.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding.

A traumatic brain injury (TBI) is a blow, jolt or penetration to the head that disrupts the function of the brain. Most TBIs are caused by falls, jumps, motor vehicle traffic crashes, being struck by a person or a blunt object, and assault. Student-athletes may be put at risk in school sports, creating concern about concussions and brain injury. A concussion can be caused by a direct blow to the head, or an indirect blow to the body that causes reactions in the brain. The result of a concussion is neurological impairment that may resolve spontaneously but may also have long-term consequences.

<span class="mw-page-title-main">Concussions in Australian sport</span>

Head injuries in sports of any level are the most dangerous kind of injuries that can occur in sport, and are becoming more common in Australian sport. Concussions are the most common side effect of a head injury and are defined as "temporary unconsciousness or confusion and other symptoms caused by a blow to the head." A concussion also falls under the category of Traumatic Brain Injury (TBI). Especially in contact sports like Australian rules football and rugby, issues with concussions are prevalent, and methods to deal with, prevent and treat concussions are continuously being updated and researched to deal with the issue. Concussions pose a serious threat to the patients’ mental and physical health, as well as their playing career, and can result in lasting brain damage especially if left untreated. The signs that a player may have a concussion are: loss of consciousness or non-responsiveness, balance problems, a dazed, blank or vacant look and/or confusion and unawareness of their surroundings. Of course the signs are relevant only after the player experiences a blow to the head.

<span class="mw-page-title-main">Caroline Finch</span> Australian statistician

Caroline Finch AO is an Australian sports injury epidemiologist and sports injury prevention researcher. Her research has been adopted and used to directly inform safety policy by Government Departments of Sport and Health, health promotion and injury prevention agencies, and peak sports bodies both within Australia and internationally. Her injury prevention research has been applied to falls in older people, road safety, workplace safety and injuries in children.

A pediatric concussion, also known as pediatric mild traumatic brain injury (mTBI), is a head trauma that impacts the brain capacity. Concussion can affect functional, emotional, cognitive and physical factors and can occur in people of all ages. Symptoms following after the concussion vary and may include confusion, disorientation, lightheadedness, nausea, vomiting, blurred vision, loss of consciousness (LOC) and environment sensitivity. Concussion symptoms may vary based on the type, severity and location of the head injury. Concussion symptoms in infants, children, and adolescents often appear immediately after the injury, however, some symptoms may arise multiple days following the injury leading to a concussion. The majority of pediatric patients recover from the symptoms within one month following the injury. 10-30% of children and adolescents have a higher risk of a delayed recovery or of experiencing concussion symptoms that are persisting.

References

  1. ↑ From Flight magazine (1912), as described by Grothe, Solfeig (March 26, 2016). "Mit dem Kopf durch die Wand (With the Head Through the Wall)". Der Spiegel (in German). Archived from the original on May 23, 2018.
  2. ↑ Kushner D (1998). "Mild Traumatic brain injury: Toward understanding manifestations and treatment". Archives of Internal Medicine. 158 (15): 1617–1624. doi:10.1001/archinte.158.15.1617. PMID   9701095.
  3. ↑ "Infographic: Important Earthquake Safety Tips". energized.edison.com. Retrieved 3 March 2023.
  4. ↑ Mayo Clinic Staff (2007). "Concussio". Mayo Clinic. Retrieved 2008-01-10.
  5. 1 2 3 4 McGuine TA, Hetzel S, McCrea M, Brooks MA (2014). "Protective equipment and player characteristics associated with the incidence of sport-related concussion in high school football players: a multifactorial prospective study". The American Journal of Sports Medicine. 42 (10): 2470–8. doi:10.1177/0363546514541926. PMC   4477806 . PMID   25060072.
  6. ↑ Levy ML, Ozgur BM, Berry C, Aryan HE, Apuzzo ML (2004). "Birth and evolution of the football helmet". Neurosurgery. 55 (3): 656–61, discussion 661–2. doi:10.1227/01.NEU.0000134599.01917.AA. PMID   15335433.
  7. 1 2 3 4 5 6 McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., & Cantu, R. (2009). Consensus Statement on Concussion in Sport – the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. South African Journal of Sports Medicine, 21(2), 36-46.
  8. ↑ Bryan, M. A., Rowhani-Rahbar, A., Comstock, R. D., & Rivara, F. (2016). Sports-and Recreation-Related Concussions in US Youth. Pediatrics, 138(1), e20154635. Access at: http://pediatrics.aappublications.org/content/early/2016/06/16/peds.2015-4635
  9. ↑ FAIR Health. (2016). Five Hundred Percent Increase in Youth Concussion Diagnoses since 2010. Access at: http://www.fairhealth.org/servlet/servlet.FileDownload?file=01532000001niFi
  10. ↑ Maddocks D, Dicker G. (1989). An objective measure of recovery from concussion in Australian rules footballers. Sport Health, 7(Supplement):6-7.
  11. ↑ Maddocks DL, Dicker GD, Saling MM (1995). "The assessment of orientation following concussion in athletes". Clinical Journal of Sport Medicine. 5 (1): 32–5. doi:10.1097/00042752-199501000-00006. PMID   7614078.
  12. ↑ McCrea M. (2001). Standardized mental status assessment of sports concussion. Clinical Journal of Sport Medicine. 11(3):176-81.
  13. ↑ McCrea M, Kelly JP, Randolph C, Kluge J, Bartolic E, Finn G, Baxter B (1998). "Standardized assessment of concussion (SAC): on-site mental status evaluation of the athlete". The Journal of Head Trauma Rehabilitation. 13 (2): 27–35. doi:10.1097/00001199-199804000-00005. PMID   9575254.
  14. ↑ McCrea M, Randolph C, Kelly J. The Standardized Assessment of Concussion(SAC): Manual for Administration, Scoring and Interpretation. 2nd ed. Waukesha, WI 2000.[ page needed ]
  15. ↑ Randolph, C. (2011). Baseline neuropsychological testing in managing sport-related concussion: does it modify risk? Current Sports Medicine Reports, 10(1):21-6.
  16. ↑ National Safety Council (2017). The State of Safety - A State-by-State Report. Itasca, IL. Pg. 32-33. accessed at: http://www.nsc.org/NSCDocuments_Advocacy/State-of-Safety/State-Report.pdf Archived 2017-07-28 at the Wayback Machine
  17. ↑ Levy ML, Ozgur BM, Berry C, Aryan HE, Apuzzo ML (2004). "Birth and evolution of the football helmet". Neurosurgery. 55 (3): 656–61, discussion 661–2. doi:10.1227/01.NEU.0000134599.01917.AA. PMID   15335433.
  18. ↑ Sulheim S, Holme I, Ekeland A, Bahr R (2006). "Helmet use and risk of head injuries in alpine skiers and snowboarders". JAMA. 295 (8): 919–24. doi:10.1001/jama.295.8.919. PMID   16493105.
  19. ↑ "Smart hockey helmet assesses players' knocks to the noggin". New Atlas. 2023-03-31. Retrieved 2023-09-04.
  20. ↑ Carron, Cécilia (2023-03-31). "Smart helmets to prevent head trauma".{{cite journal}}: Cite journal requires |journal= (help)
  21. ↑ National Football League. (2011). NFL announces new sideline concussion assessment protocol. Retrieved from http://www.nfl.com/news/story/09000d5d81e78cc4/printable/nfl-announces-new-sideline-concussion-assessment-protocol-. Retrieved April 8, 2012.
  22. ↑ Klemko, R. (2012). NFL: 2011 kickoff rule change cuts concussions in half. USA Today. Retrieved from http://content.usatoday.com/communities/thehuddle/post/2012/02/nfl-2011-kickoff-rule-change-cut-concussions-in-half/1. Retrieved April 8, 2012.
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