Neurosurgery · 2025
Mechanisms of Concussions Among High School Athletes in School-Sponsored Sports: Implications for Safety.
СтатьяНазвание и аннотация: Перевод в очереди
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Kemprecos Helen J, Shaffer Annabelle, Moran Zelda, Anderson Aaron T, Harrington Kelly, Tarr Adam, Flannell John, Huesmann Graham, Wszalek Tracey M, Zimmerman Jerrad, Arnold Paul M
Аннотация
BACKGROUND AND OBJECTIVE: Over 1 million sport-related concussions (SRCs) occur among US children annually. Enhancing sport safety requires a detailed understanding of SRC mechanisms. However, limited data characterize the specific actions causing SRCs in high-school athletes. The objective was to classify SRC mechanisms using a standardized hierarchical scheme and evaluate associations between mechanism categories and symptom profiles, overall and by sport and sex.
METHODS: This retrospective study analyzed Sport Concussion Assessment Tool (SCAT), evaluations and athletic-trainer documentation from high-school athletes (age 14-19 years) across 19 schools (2009-2023). SRCs were coded as hit-to-head and tackle/collision (present/absent) and, when applicable, by hit-to-head subtype, head contact location, and contact context (opponent/teammate; practice vs competition). Analyses included descriptive statistics, χ 2 /Fisher tests, and odds ratios (95% CIs) with Bonferroni adjustment. Symptom burden and individual symptom endorsement were compared by sex and mechanism (hit-to-head vs no hit-to-head). Logistic regressions with cluster-robust SEs, adjusted for sex and sport, assessed associations between mechanisms (and subtypes) and symptoms.
RESULTS: A total of 455 SRCs (401 athletes) were analyzed; 111 (24.4%) occurred in females. Overall, 73.6% involved a hit-to-head and 65.9% a tackle/collision, with co-occurrence in 56.0%. SRCs most frequently occurred in football (53.8%), soccer (21.1%), and basketball (8.4%). Mechanisms were sport-specific: tackling in football (38.9%), heading in soccer (54.2%), rebounding or loose-ball play in basketball (41.7%), takedowns in wrestling (83.3%), spiking in volleyball (66.7%), and stunting in cheerleading (90.5%). After adjustment for sex, sport, and tackle/collision, headache and "don't feel right" remained significantly associated with a hit-to-head mechanism. Tackle/collision was independently associated with greater odds of dizziness (adjusted odds ratios 2.07), feeling slowed (1.92), and headache (2.82).
CONCLUSION: High-school SRCs most often result from head-to-ground impacts, player collisions, or sport-specific actions such as tackling or heading. Characterizing these mechanisms can guide targeted, sport-specific prevention strategies.
METHODS: This retrospective study analyzed Sport Concussion Assessment Tool (SCAT), evaluations and athletic-trainer documentation from high-school athletes (age 14-19 years) across 19 schools (2009-2023). SRCs were coded as hit-to-head and tackle/collision (present/absent) and, when applicable, by hit-to-head subtype, head contact location, and contact context (opponent/teammate; practice vs competition). Analyses included descriptive statistics, χ 2 /Fisher tests, and odds ratios (95% CIs) with Bonferroni adjustment. Symptom burden and individual symptom endorsement were compared by sex and mechanism (hit-to-head vs no hit-to-head). Logistic regressions with cluster-robust SEs, adjusted for sex and sport, assessed associations between mechanisms (and subtypes) and symptoms.
RESULTS: A total of 455 SRCs (401 athletes) were analyzed; 111 (24.4%) occurred in females. Overall, 73.6% involved a hit-to-head and 65.9% a tackle/collision, with co-occurrence in 56.0%. SRCs most frequently occurred in football (53.8%), soccer (21.1%), and basketball (8.4%). Mechanisms were sport-specific: tackling in football (38.9%), heading in soccer (54.2%), rebounding or loose-ball play in basketball (41.7%), takedowns in wrestling (83.3%), spiking in volleyball (66.7%), and stunting in cheerleading (90.5%). After adjustment for sex, sport, and tackle/collision, headache and "don't feel right" remained significantly associated with a hit-to-head mechanism. Tackle/collision was independently associated with greater odds of dizziness (adjusted odds ratios 2.07), feeling slowed (1.92), and headache (2.82).
CONCLUSION: High-school SRCs most often result from head-to-ground impacts, player collisions, or sport-specific actions such as tackling or heading. Characterizing these mechanisms can guide targeted, sport-specific prevention strategies.