Combined concussion incidence rate doubles at three division I football programs

BALTIMORE — Three division I football programs had a two-fold increase in the combined concussion incidence rate from the previous season after implementation of new NCAA policies on concussion management, according to a presenter at the American Orthopaedic Society for Sports Medicine Annual Meeting, here.

“Possible explanations for the increase include the implementation of a concussion management plan at each institution, overall increased awareness on part of players, coaches and medical personnel or previous under-recognition on the part of players and coaches,” Kelly G. Kilcoyne, MD, said.

Kelly G. Kilcoyne

The researchers reviewed injury reports from the U.S. Military Academy, U.S. Naval Academy and U.S. Air Force Academy. All athletes were males aged 18 years to 22 years, with player rosters totaling about 150 players for practices and 90 players for games. The number of concussions that occurred during the 2009-2010 and 2010-2011 seasons, inclusive of concussions sustained in practice and game situations, was determined per team. The number of athlete exposures per season was calculated by multiplying the number of players by the number of player-exposures. Incidence rates were compared using the exact binomial method.

The combined concussion incidence rate doubled from 0.56 per 1,000 exposures in the 2009-2010 season to 1.16 per 1,000 exposures in the 2010-2011 season. The combined number of concussions for the 2009-2010 season was 23 (40,481 exposures), and 42 (36,228 exposures) for the 2010-2011 season.

Kilcoyne said that in April 2010 the NCAA Executive Committee adopted a policy requiring NCAA institutions to file a concussion management plan which calls for athletes with suspected concussions to be identified and removed from play. Additionally, athletes diagnosed with concussions cannot return to play for the remainder of the day. Players and coaches must notify a health care provider when they notice signs of a concussion and athletes must sign a statement of compliance.

While the institution of a more formalized concussion plan on the part of medical staff is a possible reason for the increase, the largest difference may be due to previous under-recognition and under-reporting on the part of players and coaches prior to the new policy, he said.

“It places more responsibility on the coaches and athletes not only to identify signs of concussion but also places the responsibility on them to report their injuries to institution medical staff. Additional studies are needed to determine the true incidence of concussions in division I football — as awareness continues to increase among health care professional, coaches and athletes,” Kilcoyne said.

Reference:

Kilcoyne KG, Dickens J, Svoboda SJ, et al. Concussion rates for three division I football programs for two consecutive seasons: A service academy review. Paper #1. Presented at the American Orthopaedic Society for Sports Medicine Annual Meeting 2012. July 12-15. Baltimore.

Disclosure: Kilcoyne has no relevant financial disclosures.