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Risk factors for sports concussion: an evidence-based systematic review
  1. Shameemah Abrahams1,
  2. Sarah Mc Fie1,
  3. Jon Patricios2,3,
  4. Michael Posthumus1,
  5. Alison V September1
  1. 1UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
  2. 2Morningside Sports Medicine and Sports Concussion South Africa, Johannesburg, South Africa
  3. 3The Section of Sports Medicine, University of Pretoria, Pretoria, South Africa
  1. Correspondence to Dr Alison V September, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town PO Box 115, Newlands 7725, South Africa; Alison.September{at}


Concussion is a common sports injury with approximately 1.6–3.8 million sport-related concussions reported in the USA annually. Identifying risk factors may help in preventing these injuries. This systematic review aims to identify such risk factors. Three electronic databases; ScienceDirect, PubMed and SpringerLink, were searched using the keywords ‘RISK FACTORS’ or ‘PREDISPOSITION’ in conjunction with ‘SPORT’ and ‘CONCUSSION’. Based on the inclusion and exclusion criteria, 13 628 identified titles were independently analysed by two of the authors to a final list of 86 articles. Only articles with a level of evidence of I, II and III were included according to robust study design and data analysis. The level of certainty for each risk factor was determined. A high level of certainty for increased risk of a subsequent concussion in athletes sustaining more than one previous concussion was reported in 10 of 13 studies. Further, a high level of certainty was assigned to match play with all 29 studies reporting an increased concussion risk during matches. All other risk factors were evaluated as having a low level of certainty. Although several risk factors were identified from the appraised studies, prospective cohort studies, larger sample sizes, consistent and robust measures of risk should be employed in future research.

  • Concussion
  • Evidence Based Reviews
  • Sporting Injuries
  • Epidemiology

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