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Concussion among military service academy members: identifying risk factors, recovery trajectories, and the role of mental health
  1. Kathryn Lacey O’Connor
    1. Correspondence to Dr Kathryn Lacey O’Connor, School of Kinesiology, University of Michigan, Ann Arbor, Michigan 48109, USA; kloconn{at}

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    What did I do?

    From a sample of 10 604 cadets, I investigated 800 concussions at three US service academies to identify factors that increase concussion risk, prolong recovery, and the relationship between concussion and psychological symptoms. The primary aim was to use multivariate methods across all concussion settings (sport, military and free time related) to achieve a more comprehensive understanding of concussion burden and outcomes.

    Why did I do it?

    Concussion is a growing concern among athletes and military personnel. Concussion rates among athletes have increased over the last 20 years1 2 and has become the signature injury of recent military conflicts.3 However, the majority of concussions among service members occur within the continental USA,4 with a mechanism similar to civilian injuries. To better understand who is at risk for concussion, specific concussion settings, such as sport-related or military-related injury, have been evaluated, but this method limits our understanding of the true concussion burden and identifying concussion-related risk factors. Additionally, most concussion recovery studies have focused on male football athletes …

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    • Contributors KLO generated aims and hypotheses, designed analysis methods, monitored data collection, assisted with data collection and training research staff on assessments, cleaned and analysed the data and drafted and revised the paper.

    • Funding This project was supported, in part, with support from the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium, funded, in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award NO W81XWH-14-2-0151. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense (DHP funds).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval University of Michigan, Indiana University, Medical College of Wisconsin, West Point, Air Force Academy, Coast Guard Academy, Human Research Protection Office.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Collaborators Darren E Campbell; Xuming He; Sean Meehan; Steven J Svoboda; Thomas McAllister; Michael McCrea; Steven P Broglio.