Our purpose was to describe the youth flag football head impact burden and make comparisons with youth tackle football. Head impact frequency and magnitude (linear acceleration [g], rotational acceleration [rad/s 2 ]) were collected from 25 tackle and 25 flag youth football players over one season. Athlete exposure (AE) was defined as one player participating in one session. Head impact rates (IR) were calculated and impact rate ratios (IRR) were used to compare youth tackle and flag football. Random-intercept generalized logit models with odds ratios compared the probabilities of sustaining an impact with a linear acceleration of 20.00-29.99g, 30.00-39.99g, and ‡40.00g against the reference of 14.00-19.99g and an impact with a rotational acceleration of 2500.00-7499.99 rad/s 2 or ‡7500.00 rad/s 2 against the reference of £2499.99 rad/s 2 between youth flag and tackle football. We observed 1908 tackle football head impacts (735 in games, 38.5%) across 624 AE and 169 flag football head impacts (101 in games, 59.8%) across 255 AE. Youth tackle football players experienced higher overall IR (3.06, 95% confidence interval [CI]: 2.61, 3.58; IRR = 4.61, 95% CI: 3.94, 5.40) compared with flag football (IR = 0.66, 95% CI: 0.57, 0.78). Youth flag football players had lower odds of sustaining impacts >20g but higher odds of sustaining impacts between 2500.00-7499.99 rad/s 2 compared with youth tackle players. Our preliminary sample of youth flag football players sustained less frequent head impacts at higher rotational accelerations than tackle football players. Flag football is considered a limited-contact sport, but little is known about the true head impact burden. Our findings may be important for policymakers when debating potential changes to youth football participation.

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ObjectiveWe aimed to quantify the female athlete composition of the research data informing the most influential consensus and position statements in treating sports-related concussions.DesignWe identified the most influential concussion consensus and position statements through citation and documented clinician use; then, we analysed the percentage of male and female athletes from each statement’s cited research.Data sourcesWe searched PubMed on 26 August 2021 with no date restrictions for English language studies using the terms ‘concussion position statement’ and ‘concussion consensus statement.’Eligibility criteria for selecting studiesBased on each statement having multiple statement editions, documented clinician use, and substantial citation advantages, we selected the National Athletic Trainers’ Association (NATA, 2014), International Conference on Concussion in Sport (ICCS, 2017) and the American Medical Society for Sports Medicine (AMSSM, 2019). We extracted all cited studies from all three papers for assessment. For each paper analysing human data, at least two authors independently recorded female athlete participant data.ResultsA total of 171 distinct studies with human participants were cited by these three consensus and position papers and included in the female athlete analyses (93 NATA; 13 ICCS; 65 AMSSM). All three statements documented a significant under-representation of female athletes in their cited literature, relying on samples that were overall 80.1% male (NATA: 79.9%, ICCS: 87.8 %, AMSSM: 79.4%). Moreover, 40.4% of these studies include no female participants at all.ConclusionFemale athletes are significantly under-represented in the studies guiding clinical care for sport-related concussion for a broad array of sports and exercise medicine clinicians. We recommend intentional recruitment and funding of gender diverse participants in concussion studies, suggest authorship teams reflect diverse perspectives, and encourage consensus statements note when cited data under-represent non-male athletes.