CoChat
Sign Up
Cited by 133Traumatic Brain Injury ResearchSports injuries and preventionWinter Sports Injuries and Performance

What are the most effective risk-reduction strategies in sport concussion?

Benson, Brian W, McIntosh, Andrew S, Maddocks, David, Herring, Stanley A, Raftery, Martin, Dvořák, Jiří·2013·British Journal of Sports Medicine
DOI 10.1136/bjsports-2013-092216
Open this paper in CoChat — free account

Abstract

AIM: To critically review the evidence to determine the efficacy and effectiveness of protective equipment, rule changes, neck strength and legislation in reducing sport concussion risk. METHODS: Electronic databases, grey literature and bibliographies were used to search the evidence using Medical Subject Headings and text words. Inclusion/exclusion criteria were used to select articles for the clinical equipment studies. The quality of evidence was assessed using epidemiological criteria regarding internal/external validity (eg, strength of design, sample size/power, bias and confounding). RESULTS: No new valid, conclusive evidence was provided to suggest the use of headgear in rugby, or mouth guards in American football, significantly reduced players' risk of concussion. No evidence was provided to suggest an association between neck strength increases and concussion risk reduction. There was evidence in ice hockey to suggest fair-play rules and eliminating body checking among 11-years-olds to 12-years-olds were effective injury prevention strategies. Evidence is lacking on the effects of legislation on concussion prevention. Equipment self-selection bias was a common limitation, as was the lack of measurement and control for potential confounding variables. Lastly, helmets need to be able to protect from impacts resulting in a head change in velocities of up to 10 and 7 m/s in professional American and Australian football, respectively, as well as reduce head resultant linear and angular acceleration to below 50 g and 1500 rad/s(2), respectively, to optimise their effectiveness. CONCLUSIONS: A multifactorial approach is needed for concussion prevention. Future well-designed and sport-specific prospective analytical studies of sufficient power are warranted.

Integrity signals

Registry

Crossref · 10.1136/bjsports-2013-092216

Cites

78 of 78 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Benson, B. W., McIntosh, A. S., Maddocks, D., Herring, S. A., Raftery, M., & Dvořák, J.
Affiliations
  • University of Calgary (CA)
  • Monash University (AU)
  • The University of Melbourne (AU)
  • University of Washington (US)
  • World Rugby (IE)
  • Schulthess-Klinik (CH)
Corresponding author
Benson, Brian W
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2013-03-11
Volume
47
Issue
5
Pages
321-326
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2013-092216
OpenAlex
W2063317682
Cited by
133
References
78
Citations by year
2026: 3 · 2025: 5 · 2024: 2 · 2023: 6 · 2022: 2 · 2021: 12 · 2020: 12 · 2019: 10 · 2018: 8 · 2017: 14 · 2016: 19 · 2015: 21 · 2014: 19
FWCI
2.33
Type
journal article
Language
en
Open access
closed
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • FedUni ResearchOnline (Federation University Australia) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Winter Sports Injuries and Performance
Keywords
sports-related concussion, concussion prevention, risk mitigation strategies, personal protective equipment, headwear, mouthguards, rugby, American football, ice hockey, neck muscle strength, body checking, concussion legislation
MeSH terms
Athletic Injuries, Biomechanical Phenomena, Brain Concussion, Equipment Design, Head Protective Devices, Humans, Mouth Protectors, Neck, Sports, Muscle, Skeletal, Risk Reduction Behavior, Muscle Strength

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review