WASHINGTON — Young athletes in the U.S. face a “culture of resistance” to reporting when they might have a concussion and to complying with treatment plans, which could endanger their well-being, says a new report from the Institute of Medicine and National Research Council. The report provides a broad examination of concussions in a variety of youth sports with athletes aged 5 to 21. Overall, reported concussions rates are more frequent among high school athletes than college athletes in some sports — including football, men’s lacrosse and soccer, and baseball; higher for competition than practice (except for cheerleading); and highest in football, ice hockey, lacrosse, wrestling, soccer, and women’s basketball. Concussion rates also appear higher for youths with a history of prior concussions and among female athletes. See full press release
Citation: Yard, E. E., & Comstock, R. D. (2011). Compliance with return to play guidelines following concussion in US high school athletes, 2005-2008. Brain Injury, 23(11), 888-898.
Review by Laszlo A. Erdodi, PhD
This was a prospective cohort study including 100 nationally representative American high schools. Concussion data were provided by certified athletic trainers through an online reporting system. Injuries were retrospectively graded according to AAN and Prague return-to-play (RTP) guidelines. The strengths of the study are a large, demographically representative sample; simultaneous comparison of concussion rates based on AAN and Prague classification; reporting data separately for gender, concussion severity and type of sport. Some of the weaknesses are selection bias (inclusion criteria favor better regulated institutions); imperfection in reporting system (insufficient detail to confidently classify a given incident); and concussion severity classification was performed post hoc.