Traumatic Brain Injury In Sport: Incidence of Injury Kevin Guskiewicz, PhD, ATC Kenan Distinguished Professor Department of Exercise and Sport Science UNIVERSITY of NORTH CAROLINA at CHAPEL HILL iversity of Michigan Injury Center Concussion Summit Sept. 24, 2015
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Traumatic Brain Injury in Sport: Incidence of Injury by Kevin Guskiewicz
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Traumatic Brain Injury In Sport: Incidence of Injury
Kevin Guskiewicz, PhD, ATCKenan Distinguished Professor
Department of Exercise and Sport ScienceUNIVERSITY of NORTH CAROLINA at CHAPEL HILL
University of Michigan Injury CenterConcussion Summit Sept. 24, 2015
Are football programs’ millions in profits exploitation? Or are they still a celebration of amateur sport?
Does football’s inherent danger and violence have any place in institutions of higher learning? Or does it provide young men with educational opportunities they would not otherwise have?Arguing for the motion will be Malcolm Gladwell and Buzz Bissinger, arguing against will be Jason Whitlock and Tim Green.
May 8, 2012 – On-line debate FOR A.tv
10 Ideas That Changed the World in 2012
Cumulative risks for youth athletes
Should kids be playing contact or collision sports?
National Center for Catastrophic Sport Injury Research: Direct (traumatic) Head and Neck Catastrophic Injuries – All sports all levels
1985-1989
1990-1994
1995-1999
2000-2004
2005-2009
2010-2014
0
50
100
150
200
250
300
Total Fatal Non-fatal neck Non-fatal Head
Num
ber o
f eve
nts
Catastrophic Head & Neck Injuries Academic Year 2014-15
Sport n % Football 22 84.6 Lacrosse 1 3.9 Soccer 3 11.5Level Professional 3 11.5 Collegiate 4 15.4 High school 18 69.2 Youth league 1 3.9Part Head 13 50.0 Neck 12 46.2 Spine 1 3.9
Cheerleaders don’t always have a safe practice space. Cheerleading practice concussions occur on tile, asphalt, and concrete.
Courtesy of R. Dawn Comstock, PhD; National High School Sports-Related Injury Surveillance System (High School RIO)
Concussion Burden High School RIOTM Data
Courtesy of R. Dawn Comstock, PhD; National High School Sports-Related Injury Surveillance System (High School RIO)
State Concussion LawsSports Concussion Legislation – All 50 states (2009-2014) Essential components
1) Education (athletes, parents, coaches).
2) Instituting a concussion policy and emergency action plan.
3) Removal from practice or play at the time of suspected concussion.
4) Medical evaluation and return to play clearance by a health care provider with training in concussion management.
State Youth Sport Concussion Laws Enacted by Year
K.M. Lowrey, 2014
Concussion Rates per 10,000 AE Over Time: High School RIO Data
Courtesy of R. Dawn Comstock, PhD; National High School Sports-Related Injury Surveillance System (High School RIO)
Concussion crisis?No!
Trends Over Time: Compliance with Return to Play Guidelines Following Concussion (All Sports)
07/08 08/09 09/10 10/11 11/12 12/13
<1 day 7.9 2.6 1.5 0.8 1.8 0.6
1-2 days 6.7 6.4 3.9 2.4 1.9 0.8
3-6 days 21.4 19.5 17.9 12.9 8.9 8.3
Season ended 0.8 0.1 8.7 12.2 14.2 14.5
Athlete decides not to continue
0.4 1.4 1.2 1.4 1.9 1.9
% of Student Athletes in Each Category of RTP by Year
“Education (coupled with legislation?) has been effective!”Courtesy of R. Dawn Comstock, PhD;
National High School Sports-Related Injury Surveillance System (High School RIO)
Across 25 sports, no significant increase detected over the past 10 years; Lacrosse and football showed linear trends suggesting an increase in reported concussions.
Concussion Incidence
• HS overall rate (2011/12 HS RIO): 0.51 per 1,000 AEs – 2x greater than rate for 2005/2006 season
Rosenthal, 2014
• NCAA overall rate (2009/2010 to 2013/2014 NCAA ISS):0. 447 per 1,000 AEs
Zuckerman, 2015
Concussion incidence in the NFL
• 1996 – 2001: 0.41 concussions per game (Pellman et al, 2004)
• 2002 – 2007: 0.38 concussions per game (Casson et al, 2010)
• 2010 – 2014: 0.66 concussions per game (Clark et al, Unpublished)
Incidence rate by type of play (NFL)
Type of Play Injuries Frequency of
Play Type
Adjusted Frequency of Play Types Incidence Rate per 1,000