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12.10 Concussion rates in U.S. middle school athletes from the 2015–2016 to 2019–2020 school years
  1. Samantha Hacherl1,
  2. Patricia Kelshaw2,
  3. Nicholas Erdman1,
  4. Jatin Ambegaonkar1,
  5. Shane Caswell1
  1. 1Sports Medicine Assessment, Research and Testing Laboratory, ACHIEVES Project, George Mason University, Manassas, USA
  2. 2Athletic Training Program, Department of Kinesiology, University of New Hampshire, Durham, USA

Abstract

Objective To describe the epidemiology of concussions among middle school (MS) age athletes from 2015 to 2020.

Design Prospective observational cohort.

Setting Metropolitan school division in Virginia, USA.

Participants 7,779 athletes at 16 middle schools (age= 12.4 ±1.0 years).

Outcome Measures Certified athletic trainers collected concussion and athlete exposure (AE) data for all MS sponsored sports events. Concussion rates per 1000 AEs and injury rate ratios (IRR) were calculated to compare concussion rates (IR) between practice and competition for 12 school-sponsored sports (baseball, football, wrestling, boys’/girls’ basketball, cheerleading, boys’/girls’ soccer, softball, boys’/girls’ track, and volleyball). IRs and IRRs with 95% CI excluding 1.00 were deemed statistically significant.

Main Results 231 concussions occurred during 390,562 AEs for overall concussion rate of 0.59/1,000 AE (95%CI=0.52–0.67). Sports with the highest IRs were football (1.38/1000 AE, 95%CI= 1.06–1.69), girls’ soccer (1.26/1000 AE, 95%CI= 0.77–1.75), and wrestling (1.12/1000 AE, 95%CI= 0.78–1.46). Concussion rates were higher during competition (IR: 1.06 , 95%CI: 0.85 -1.26) than practice (IR:0.44 , 95% CI 0.37–0.52; IRRcompetition/practice: =2.38, 95%CI= 1.84–3.09)

Conclusions Findings from this large multi-year study revealed MS athletes to have an overall higher concussion rate than reported among older athletes. Football followed by girls soccer had the highest concussion rates among all MS sports. Overall, MS athletes were two times more likely to sustain a concussion during competition than practice. These findings are consistent with prior MS and HS research. Our findings reinforce the importance of onsite medical services within middle school sport settings.

https://doi.org/10.1136/bjsports-2023-concussion.179

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