Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study-Reference-Cited by-同舟云学术

Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study

Published:2024-04-24 Issue:6 Volume:52 Page:1585-1595
ISSN:0363-5465
Container-title:The American Journal of Sports Medicine
language:en
Short-container-title:Am J Sports Med

Author:

Jo Jacob¹²^ORCID,Boltz Adrian J.³²,Williams Kristen L.⁴²,Pasquina Paul F.⁵²,McAllister Thomas W.⁶²,McCrea Michael A.⁷²,Broglio Steven P.³²,Zuckerman Scott L.⁴²,Terry Douglas P.⁸², ,Arbogast Kristy⁹²,Benjamin Holly J.¹⁰²,Brooks Alison¹¹²,Cameron Kenneth L.¹²²,Chrisman Sara P.D.¹³²,Clugston James R.¹⁴²,Collins Micky¹⁵²,DiFiori John¹⁶²,Eckner James T.¹⁷²,Estevez Carlos¹⁸²,Feigenbaum Luis A.¹⁹²,Goldman Joshua T.²⁰²,Hoy April²¹²,Kaminski Thomas W.²²²,Kelly Louise A.²³²,Kontos Anthony P.¹⁵²,Langford Dianne²⁴²,Lintner Laura J.²⁵²,Master Christina L.⁹²,McDevitt Jane²⁴²,McGinty Gerald²⁶²,Miles Chris²⁷²,Ortega Justus²⁸²,Port Nicholas²⁹²,Rowson Steve³⁰²,Schmidt Julianne³¹²,Susmarski Adam³²²,Svoboda Steven³³²

Affiliation:

1. Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA

2. Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA

3. Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA

4. Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA

5. Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA

6. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA

7. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

8. Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA

9. University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

10. University of Chicago, Chicago, Illinois, USA

11. University of Wisconsin–Madison, Madison, Wisconsin, USA

12. United States Military Academy, West Point, New York, USA)

13. University of Washington, Seattle, Washington, USA)

14. University of Florida, Gainesville, Florida, USA

15. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

16. Hospital for Special Surgery, New York, New York, USA)

17. University of Michigan, Michigan, USA)

18. United States Coast Guard Academy, New London, Connecticut, USA

19. University of Miami, Coral Gables, Florida, USA

20. University of California, Los Angeles, Los Angeles, California, USA

21. Azusa Pacific University, Azusa, California, USA

22. University of Delaware, Newark, Delaware, USA

23. California Lutheran University, Thousand Oaks, California, USA

24. Temple University, Philadelphia, Pennsylvania, USA

25. Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

26. United States Air Force Academy, El Paso, Colorado, USA

27. Wake Forest University, Winston-Salem, North Carolina, USA

28. California State Polytechnic University, Pomona, California, USA

29. Indiana University, Bloomington, Indiana, USA

30. Virginia Tech, Blacksburg, Virginia, USA

31. University of Georgia, Athens, Georgia, USA)

32. United States Naval Academy, Annapolis, Maryland, USA)

33. MedStar Health, Columbia, Maryland, USA

Abstract

Background: Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes. Purpose: To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground/equipment. Baseline/acute injury characteristics—including Sports Concussion Assessment Tool–3 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)—were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP/URTP, respectively. Results: Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground/equipment mechanism. Event type was significantly associated with injury mechanism [χ2(3) = 63; P < .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [χ2(3) = 24; P < .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism ( P = .034), with LOC being most prevalent in head-to-ground/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [χ2(3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP ( P = .044), with head-to-equipment/ground injuries resulting in the shortest mean number of days (14 ± 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 ± 21.6 days). Conclusion: The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.

Funder

National Collegiate Athletic Association

Publisher

SAGE Publications

Link

https://journals.sagepub.com/doi/pdf/10.1177/03635465241240789

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