In the Journals

Recurrent concussion rates decline following youth traumatic brain injury laws

The rate of recurrent concussions significantly decreased among high-school athletes in the 2 years following the enactment of youth sports traumatic brain injury laws in the United States, according to results published in American Journal of Public Health.

However, because more people learned how to distinguish the signs of concussion, the reported rates of new and recurrent concussions increased immediately after the enactment of these laws, according to the study findings.

“Most [traumatic brain injury (TBI)] laws require athletes, athletic trainers and/or coaches to report all suspected and/or actual TBIs and concussions. So, what happens is that after the law is enacted you see an initial increase because more people become aware of the symptoms and signs of concussion,” Jingzhen Yang, PhD, MPH, from the Center for Injury Research and Policy at Nationwide Children’s Hospital, and the departments of pediatrics and epidemiology at The Ohio State University, said in a press release. “Many concussions that were going unreported or undiagnosed before are starting to get reported.”

For athletes in the U.S., TBI laws often mandate removal from play after actual or suspected concussion, return to play clearance and the education of coaches, parents and athletes on concussion signs and symptoms. Researchers analyzed concussion data from 2005-2016 to determine and compare the trends of new and recurrent sports-related concussions in high school athletes who participated in at least one of nine sports before and after the enactment of state-level TBI laws.

In total, approximately 2.7 million reported concussions occurred in these high school sports during the study period, according to the press release. Of the 8,043 reported concussions included in this analysis, 88.7% were new and 11.3% were recurrent. Although researchers observed increased trends in reported new and recurrent concussions before and for a period after the TBI laws were passed, the recurrent concussion rate showed a significant decrease 2.6 years later. These findings suggest that more people are identifying and reporting concussions, and it is helping school-age athletes in the long term.

Analysis revealed that concussions occurred more frequently among male athletes, in football, and during competitions. Football, girls' soccer and boys' wrestling had the three highest annual concussion rates. In general, boys had a higher average annual concussion rate compared with girls; however, when Yang and colleagues looked at the rates in gender-comparable sports like basketball, soccer and baseball/softball, girls had almost double the annual rate of concussions as boys.

"We were pleased to see that the laws are getting people to report initial concussions and are reducing the rate of recurrent concussions," Yang said in the release. "The laws are a great first step but there is still work to be done. We need to do a better job of finding ways to prevent concussions from happening in the first place." – by Savannah Demko

Disclosures: Infectious Diseases in Children was unable to determine researchers’ relevant financial disclosures prior to publication.

The rate of recurrent concussions significantly decreased among high-school athletes in the 2 years following the enactment of youth sports traumatic brain injury laws in the United States, according to results published in American Journal of Public Health.

However, because more people learned how to distinguish the signs of concussion, the reported rates of new and recurrent concussions increased immediately after the enactment of these laws, according to the study findings.

“Most [traumatic brain injury (TBI)] laws require athletes, athletic trainers and/or coaches to report all suspected and/or actual TBIs and concussions. So, what happens is that after the law is enacted you see an initial increase because more people become aware of the symptoms and signs of concussion,” Jingzhen Yang, PhD, MPH, from the Center for Injury Research and Policy at Nationwide Children’s Hospital, and the departments of pediatrics and epidemiology at The Ohio State University, said in a press release. “Many concussions that were going unreported or undiagnosed before are starting to get reported.”

For athletes in the U.S., TBI laws often mandate removal from play after actual or suspected concussion, return to play clearance and the education of coaches, parents and athletes on concussion signs and symptoms. Researchers analyzed concussion data from 2005-2016 to determine and compare the trends of new and recurrent sports-related concussions in high school athletes who participated in at least one of nine sports before and after the enactment of state-level TBI laws.

In total, approximately 2.7 million reported concussions occurred in these high school sports during the study period, according to the press release. Of the 8,043 reported concussions included in this analysis, 88.7% were new and 11.3% were recurrent. Although researchers observed increased trends in reported new and recurrent concussions before and for a period after the TBI laws were passed, the recurrent concussion rate showed a significant decrease 2.6 years later. These findings suggest that more people are identifying and reporting concussions, and it is helping school-age athletes in the long term.

Analysis revealed that concussions occurred more frequently among male athletes, in football, and during competitions. Football, girls' soccer and boys' wrestling had the three highest annual concussion rates. In general, boys had a higher average annual concussion rate compared with girls; however, when Yang and colleagues looked at the rates in gender-comparable sports like basketball, soccer and baseball/softball, girls had almost double the annual rate of concussions as boys.

"We were pleased to see that the laws are getting people to report initial concussions and are reducing the rate of recurrent concussions," Yang said in the release. "The laws are a great first step but there is still work to be done. We need to do a better job of finding ways to prevent concussions from happening in the first place." – by Savannah Demko

Disclosures: Infectious Diseases in Children was unable to determine researchers’ relevant financial disclosures prior to publication.