Fortington Lauren V, Twomey Dara M, Finch Caroline F
Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia.
Faculty of Health, Federation University Australia, Ballarat, Australia.
Inj Epidemiol. 2015 Dec;2(1):20. doi: 10.1186/s40621-015-0052-5. Epub 2015 Sep 10.
Head injuries, particularly concussion, are a major cause of concern in many sports, particularly the football codes, driving a need to better understand injury mechanisms and potential methods of prevention. The aim of this study was to describe the mechanisms and follow up care of concussion injuries sustained in adult male community Australian football to identify target areas for prevention and management.
Secondary analysis of injury data collected in a cluster randomised controlled trial in community Australian football across two states of Australia in 2007 and 2008. There were 1564 players from 18 clubs. The main outcome measures were the number and rate of head/neck/face (HNF) injuries and concussion sustained in games. A specific description of the mechanisms of the concussion injuries is presented along with the immediate return-to-play status of concussion cases.
143 HNF injuries were sustained by 132 players. The game HNF injury incidence was 4.9 per 1000 game hours (n = 138; 95 % confidence interval 4.1; 5.7). Just under a quarter (n = 34) of all HNF injuries were recorded as concussion. All concussions occurred during games (none in training), with all but one related to body contact with other players. Overall, 68 % of the concussions were considered within game rules, while 32 % were either outside of the rules or unclear. Most (88 %) players left the field immediately following concussion but 47 % later returned to play in the same game.
Prevention strategies for concussion need to be based on knowledge of the mechanisms of injury. Most concussions in community Australian football occurred through body contact with other players or during tackling. Management of players post-concussion was generally poor with over half of the cases continuing to play in the same game. Therefore, new primary prevention strategies that target body-contact/tackling skills and improved secondary prevention measures relating to compliance with return-to-play protocols would be valuable.
头部损伤，尤其是脑震荡，是许多运动项目（特别是橄榄球相关赛事）中主要的关注问题，这促使人们需要更好地了解损伤机制和潜在的预防方法。本研究的目的是描述成年男性社区澳大利亚式橄榄球运动中脑震荡损伤的机制及后续护理情况，以确定预防和管理的目标领域。
对2007年和2008年在澳大利亚两个州进行的社区澳大利亚式橄榄球集群随机对照试验中收集的损伤数据进行二次分析。共有来自18个俱乐部的1564名球员。主要观察指标为比赛中头部/颈部/面部（HNF）损伤和脑震荡的数量及发生率。文中给出了脑震荡损伤机制的具体描述以及脑震荡病例的即时重返比赛状态。
132名球员遭受了143次HNF损伤。比赛中HNF损伤发生率为每1000比赛小时4.9次（n = 138；95%置信区间4.1；5.7）。所有HNF损伤中略低于四分之一（n = 34）被记录为脑震荡。所有脑震荡均发生在比赛期间（训练中无），除一例外均与和其他球员的身体接触有关。总体而言，68%的脑震荡被认为是在比赛规则范围内，而32%要么超出规则范围，要么情况不明。大多数（88%）球员在脑震荡后立即离场，但47%的球员后来又回到同一场比赛中继续参赛。
脑震荡的预防策略需要基于对损伤机制的了解。社区澳大利亚式橄榄球运动中的大多数脑震荡是通过与其他球员的身体接触或在擒抱过程中发生的。脑震荡后球员的管理普遍较差，超过半数的病例继续在同一场比赛中参赛。因此，针对身体接触/擒抱技巧的新的一级预防策略以及与遵守重返比赛协议相关的改进后的二级预防措施将很有价值。
