2021 ISAKOS Biennial Congress ePoster
Targeting Rule Implementation Decreases Concussions In High School Football: A National Concussion Surveillance Study
Kyle Kosei Obana, BA, Honolulu, HI UNITED STATES
John D Mueller, MD, New York, New York UNITED STATES
Bryan M. Saltzman, BA, Chicago, IL UNITED STATES
Thomas S Bottiglieri, DO, New York, New York UNITED STATES
Christopher S. Ahmad, MD, New York, NY UNITED STATES
Robert L Parisien, MD, New York, NY UNITED STATES
David P Trofa, MD, Eastchester, NY UNITED STATES
Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, New York, UNITED STATES
FDA Status Not Applicable
Summary
Rates of emergency department diagnosed concussions in high school football players decreased following 2014 NFHS targeting rule implementation.
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Abstract
Introduction
Concussions occur at higher rates in high school football as compared to all other high school sports. In 2014 the National Federation of State High School Associations (NFHS) implemented rules defining illegal contact against a defenseless player above the shoulders to reduce concussions in football players. To our knowledge, rates of emergency department (ED) diagnosed concussions of high school football players before and after the 2014 rule implementation have not been compared. Accordingly, this study analyzes the rates of emergency department (ED) diagnosed concussions of high school football players after 2014 NFHS rule implementation.
Methods
Data from the National Electronic Injury Surveillance System were analyzed for high school football players 14 to 18 years old sustaining a concussion from January 1, 2009 to December 31, 2019. Data were collected on mechanism of injury, setting, loss of consciousness (LOC), and concomitant fracture.
Results
Between 2009 and 2019, an estimated 154,221 high school football concussions were diagnosed in United States EDs. 59.6% of concussions occurred during competition compared to 40.4% during practice. Overall rates of concussions decreased from +10.7% between 2009-2013 to -6.2% from 2015-2019 (p<0.05). Rate of change of helmet-to-helmet concussions decreased from +17.6% to -5.6% before and after 2014, respectively (p<0.05). There were no significant changes between other mechanisms of concussion before and after the 2014 rule implementation.
Conclusion
This study is the first to identify a decreased trend in overall and helmet-to-helmet related high school concussions diagnosed in the ED following implementation of the targeting rule. This study adds to the growing literature regarding the importance and efficacy of rule implementation in reducing sports-related concussions.