Frederick P. Rivara, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104, USA.
Am J Sports Med. 2014 May;42(5):1197-203. doi: 10.1177/0363546514521774. Epub 2014 Feb 25.
Increasing attention has been paid to concussions and especially sports-related concussions in youth. To prevent an inappropriate return to play while symptomatic, nearly all states have now passed legislation on youth sports-related concussions.
To determine (1) the incidence of sports-related concussions in high school athletes using a unique system to collect reports on concussions, (2) the proportion of athletes with concussions who play with concussive symptoms, and (3) the effect of the type and modality of coach education on the likelihood of athletes reporting symptoms to the coach or playing with concussive symptoms.
Cohort study; Level of evidence, 2.
This study was conducted with high school football and girls' soccer athletes playing in fall 2012 and their coaches and parents in 20 urban or rural high schools in Washington State. The main outcome was the incidence of concussions per 1000 athlete-exposures (AEs), the proportion of concussed athletes who played with concussive symptoms, and the association of coach concussion education with coach awareness of athletes with concussive symptoms.
Among the 778 athletes, the rate of concussions was 3.6 per 1000 AEs and was identical for the 2 sports studied. The cumulative concussion incidence over the course of the season was similar in girls' soccer (11.1%) and football (10.4%). Sixty-nine percent of concussed athletes reported playing with symptoms, and 40% reported that their coach was not aware of their concussion. Most measures of coach concussion education were not associated with coach awareness of concussions in their athletes, although the modalities of a video and quiz were associated with a lower likelihood of coach awareness.
More objective and accurate methods are needed to identify concussions. Changes in athlete attitudes on reporting concussive symptoms will likely not be accomplished through legislation alone.
人们越来越关注脑震荡，尤其是青少年的运动相关性脑震荡。为了防止出现症状后不当重返赛场，几乎所有州都针对青少年运动相关性脑震荡通过了立法。
旨在（1）利用独特的报告系统确定高中运动员运动相关性脑震荡的发生率；（2）明确患有脑震荡的运动员中伴有脑震荡症状继续比赛的比例；（3）研究教练教育的类型和模式对运动员向教练报告症状或伴有脑震荡症状继续比赛的可能性的影响。
队列研究；证据等级，2 级。
本研究对 2012 年秋季参加华盛顿州 20 所城市或农村高中的美式足球和女子足球运动员及其教练和家长进行了研究。主要结局指标为每 1000 名运动员暴露（AE）中脑震荡的发生率、患有脑震荡的运动员中伴有脑震荡症状继续比赛的比例，以及教练脑震荡教育与教练对伴有脑震荡症状运动员的意识之间的关联。
在 778 名运动员中，脑震荡发生率为每 1000AE 3.6 例，2 项研究中的发生率相同。整个赛季中，女子足球和足球的累积脑震荡发生率相似（分别为 11.1%和 10.4%）。69%的脑震荡运动员报告伴有症状继续比赛，40%报告其教练不知道他们的脑震荡。虽然视频和测验等多种教练脑震荡教育措施与教练对运动员脑震荡的意识较低有关，但大多数教练脑震荡教育措施与教练对脑震荡的意识无关。
需要更客观和准确的方法来识别脑震荡。仅通过立法改变运动员对报告脑震荡症状的态度可能不会实现。
