A Model of Prevention of Sports Concussion in Adults

Abstract

This article discusses the definitions of prevention and presents a model that addresses multidimensional aspects of sports concussion prevention from the perspectives of epidemiology, education, environmental modification, enforcement, and evaluation. Epidemiology is helpful in identifying the incidence of concussion and the interventions most likely to reduce its occurrence. Education ensures that accurate information on concussion is communicated to stakeholders. Modifications in the physical and sociocultural environments may lessen the potential for injury and reduce the risk of concussion. Enforcement of legislation standards can be effective in concussion prevention, especially at the preinjury and injury phases. The evaluation dimension assesses the effectiveness of prevention programs and guides future program development. This five-E model explains concussion prevention as a recursive loop process. Each dimension is closely associated in the prevention of sports concussion.

Keywords

Sports concussion - prevention - five-E

• References

• 1 Christoffel T, Gallagher SS. Injury Prevention and Public Health: Practical Knowledge, Skills, and Strategies. Gaithersburg, MD: Aspen; 1999
• 2 Tator CH. Sport concussion education and prevention. J Clin Sport Psychol 2012; 6: 293-301
• 3 Hinton RY. Sports injury surveillance systems. Sports Med Updates [serial online] 2012; January/February: 2–7. Available at: https://www.sportsmed.org/uploadedFiles/Content/Medical_Professionals/Professional_Educational_Resources/Publications_and_Resources/Sports_Medicine_Update/SMU_2012/SportsInjurySurveillance_JANFEB2012.pdf . Accessed April 7, 2014
• 4 Dick R, Agel J, Marshall SW. National Collegiate Athletic Association injury surveillance system commentaries: introduction and methods. J Athl Train 2007; 42 (2) 173-182
• 5 Datalys Center NCAA injury surveillance. Available at: http://datalyscenter.org/programs/ncaa-injury-surveillance-program/ Accessed April 29, 2014.
• 6 Giza CC, Kutcher JS, Ashwal S , et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013; 80 (24) 2250-2257
• 7 Field M, Collins MW, Lovell MR, Maroon J. Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. J Pediatr 2003; 142 (5) 546-553
• 8 Covassin T, Elbin R, Kontos A, Larson E. Investigating baseline neurocognitive performance between male and female athletes with a history of multiple concussion. J Neurol Neurosurg Psychiatry 2010; 81 (6) 597-601
• 9 Colvin AC, Mullen J, Lovell MR, West RV, Collins MW, Groh M. The role of concussion history and gender in recovery from soccer-related concussion. Am J Sports Med 2009; 37 (9) 1699-1704
• 10 Dick RW. Is there a gender difference in concussion incidence and outcomes?. Br J Sports Med 2009; 43 (Suppl. 01) i46-i50
• 11 Gessel LM, Fields SK, Collins CL, Dick RW, Comstock RD. Concussions among United States high school and collegiate athletes. J Athl Train 2007; 42 (4) 495-503
• 12 Provvidenza C, Engebretsen L, Tator C , et al. From consensus to action: knowledge transfer, education and influencing policy on sports concussion. Br J Sports Med 2013; 47 (5) 332-338
• 13 Harmon KG, Drezner JA, Gammons M , et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013; 47 (1) 15-26
• 14 Covassin T, Elbin RJ, Sarmiento K. Educating coaches about concussion in sports: evaluation of the CDC's “Heads Up: Concussion in Youth Sports” initiative. J Sch Health 2012; 82 (5) 233-238
• 15 Adler RH, Herring SA. Changing the culture of concussion: education meets legislation. PM R 2011; 3 (10) (Suppl. 02) S468-S470
• 16 Navarro RR. Protective equipment and the prevention of concussion—what is the evidence?. Curr Sports Med Rep 2011; 10 (1) 27-31
• 17 Cusimano MD, Taback NA, McFaull SR, Hodgins R, Bekele TM, Elfeki N. Canadian Research Team in Traumatic Brain Injury and Violence. Effect of bodychecking on rate of injuries among minor hockey players. Open Med 2011; 5 (1) e57-e64
• 18 Roberts WO, Brust JD, Leonard B, Hebert BJ. Fair-play rules and injury reduction in ice hockey. Arch Pediatr Adolesc Med 1996; 150 (2) 140-145
• 19 Brunelle JP, Goulet C, Arguin H. Promoting respect for the rules and injury prevention in ice hockey: evaluation of the fair-play program. J Sci Med Sport 2005; 8 (3) 294-304
• 20 Cusimano MD, Sharma B, Lawrence DW, Ilie G, Silverberg S, Jones R. Trends in North American newspaper reporting of brain injury in ice hockey. PLoS ONE 2013; 8 (4) e61865
• 21 Tomei KL, Doe C, Prestigiacomo CJ, Gandhi CD. Comparative analysis of state-level concussion legislation and review of current practices in concussion. Neurosurg Focus 2012; 33 (6):E11, 1-9
• 22 Breslow JM. Public Broadcasting Service. Judge rejects $765 million NFL concussion settlement. Available at: http://www.pbs.org/wgbh/pages/frontline/sports/league-of-denial/judge-rejects-765-million-nfl-concussion-settlement/ Updated January 14, 2014 . Accessed April 29, 2014
• 23 Van Tiggelen D, Wickes S, Stevens V, Roosen P, Witvrouw E. Effective prevention of sports injuries: a model integrating efficacy, efficiency, compliance and risk-taking behaviour. Br J Sports Med 2008; 42 (8) 648-652
• 24 Shenouda C, Hendrickson P, Davenport K, Barber J, Bell KR. The effects of concussion legislation one year later—what have we learned: a descriptive pilot survey of youth soccer player associates. PM R 2012; 4 (6) 427-435
• 25 Chrisman SP, Schiff MA, Chung SK, Herring SA, Rivara FP. Implementation of concussion legislation and extent of concussion education for athletes, parents, and coaches in Washington State. Am J Sports Med 2014; 42 (5) 1190-1196