高中橄榄球运动相关脑震荡预防途径：限制碰撞练习的效果。
Avenues for Sport-Related Concussion Prevention in High School Football: Effect of Limiting Collision Practices.
机构信息
Penn Injury Science Center, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia.
Department of Kinesiology, Michigan State University, East Lansing.
出版信息
J Athl Train. 2022 Aug 1;57(8):733-740. doi: 10.4085/1062-6050-0341.21.
CONTEXT
Football continues to demonstrate the highest rate of sport-related concussion (SRC) in high school athletics. To mitigate the SRC risk, the Michigan High School Athletic Association (MHSAA) implemented rules aimed at reducing the number of collisions occurring in practices.
OBJECTIVE
To estimate the rates of SRC in MHSAA football programs and evaluate progressive limitations to collision practices over 5 consecutive seasons.
DESIGN
Retrospective cohort study.
SETTING
Michigan high school football.
PATIENTS OR OTHER PARTICIPANTS
High school (9th-12th grade) football athletes (>99% male) participating in MHSAA-sanctioned events.
MAIN OUTCOME MEASURE(S): Designated administrators at each school recorded the total number of participating athletes and SRCs (defined as head injuries resulting from athletic participation that required the student-athletes to be withheld from activity after exhibiting signs, symptoms, or behaviors consistent with an SRC) in the MHSAA injury-surveillance system each season (2015-2016 through 2019-2020). Progressive limitations to collision practices occurred across the study period. We estimated athlete-exposures (AEs) as the total number of players multiplied by the total number of possible practices (11 weeks, 4 days each) or competitions (9 weeks, 1 day each) during each season. Incidence rates and rate ratios (RRs) with 95% CIs were used to compare practice and competition SRCs and each season with the most recent season.
RESULTS
A total of 7755 football SRCs were diagnosed across the 5-year period. The overall SRC rate was 8.03 per 10 000 AEs (95% CI = 7.85, 8.21). The competition SRC rate (30.13/10 000 AEs) was higher than the practice rate (3.51/10 000 AEs; RR = 8.58; 95% CI = 8.19, 9.00). The practice SRC rate was lower in 2017-2018 (RR = 0.86; 95% CI = 0.77, 0.97), 2018-2019 (RR = 0.89; 95% CI = 0.79, 1.0), and 2019-2020 (RR = 0.83; 95% CI = 0.74, 0.94) relative to 2015-2016.
CONCLUSIONS
We found that the progressive limitations to collision practices were protective against SRCs, as the rate of SRC was lower in the 3 most recent seasons relative to 2015-2016.
背景
足球仍然是高中运动相关脑震荡（SRC）发生率最高的运动项目。为了降低 SRC 风险，密歇根高中体育协会（MHSAA）实施了旨在减少练习中碰撞次数的规则。
目的
估计 MHSAA 足球项目中的 SRC 发生率，并评估连续 5 个赛季中对碰撞练习的渐进限制。
设计
回顾性队列研究。
地点
密歇根高中足球。
患者或其他参与者
参加 MHSAA 认可活动的高中（9-12 年级）足球运动员（>99%为男性）。
主要观察指标
每个学校的指定管理员在每个赛季（2015-2016 年至 2019-2020 年）的 MHSAA 伤害监测系统中记录参与运动员的总数和 SRC 数量（定义为由于运动参与而导致的头部受伤，学生运动员在出现与 SRC 一致的迹象、症状或行为后需要停止活动）。在整个研究期间，对碰撞练习的限制逐渐增加。我们将运动员暴露量（AE）估计为球员总数乘以每个赛季（11 周，每周 4 天）或比赛（9 周，每周 1 天）的总可能练习次数。使用发病率和率比（RR）及其 95%置信区间（CI）来比较练习和比赛中的 SRC，并将每个赛季与最近的赛季进行比较。
结果
在 5 年期间共诊断出 7755 例足球 SRC。总体 SRC 发生率为每 10000AE 8.03（95%CI=7.85，8.21）。比赛 SRC 发生率（30.13/10000AE）高于练习发生率（3.51/10000AE；RR=8.58；95%CI=8.19，9.00）。与 2015-2016 年相比，2017-2018 年（RR=0.86；95%CI=0.77，0.97）、2018-2019 年（RR=0.89；95%CI=0.79，1.0）和 2019-2020 年（RR=0.83；95%CI=0.74，0.94）的练习 SRC 发生率较低。
结论
我们发现，对碰撞练习的渐进限制是保护 SRC 的，因为与 2015-2016 年相比，最近 3 个赛季的 SRC 发生率较低。
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