Association Between History of Multiple Concussions and Health Outcomes Among Former College Football Players: 15-Year Follow-up From the NCAA Concussion Study (1999-2001)

Kerr, Zachary Y.; Thomas, Leah; Simon, Janet E.; McCrea, Michael; Guskiewicz, Kevin M.

doi:10.1177/0363546518765121

Cited by 65 publications

(50 citation statements)

References 42 publications

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“…Kerr et al 388 reported a 5.8-fold increased risk of depression after 5–9 concussions in retired professional football players, and Guskiewicz and colleagues389 described a 3-fold increased risk of depression following three or more SRCs among retired football players. Similarly, Kerr et al 390 reported a higher prevalence of moderate/severe depression among former collegiate football players with a history of three or more concussions. Although Fralick and colleagues391 found a twofold higher risk of suicide in individuals who experienced concussion and/or mild traumatic brain injury, this study was not athlete or sport specific, and included the general population.…”

Section: Specific Mental Health Symptoms and Disorders In Elite Athletesmentioning

confidence: 89%

“…Undesired and involuntary retirement from sport (eg, because of injury or deselection from sport) is especially associated with an increased risk of mental health symptoms and disorders among transitioning athletes 8 661 664–668. Concussion in sport is associated with subsequent mental health symptoms and disorders among retired elite athletes; however, a causal relationship has not been established 16 390 594 669–672. Other factors associated with adjustment difficulties and mental health symptoms and disorders among former elite athletes include high levels of athletic identity, lack of retirement planning, lower educational attainment, adverse life events, post-sport unemployment and chronic pain 9 18 662 668 673 674…”

Section: Major Stressors and Key Environmental Factors That Influencementioning

confidence: 99%

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Mental health in elite athletes: International Olympic Committee consensus statement (2019)

et al. 2019

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Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.

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Section: Specific Mental Health Symptoms and Disorders In Elite Athletesmentioning

confidence: 89%

Section: Major Stressors and Key Environmental Factors That Influencementioning

confidence: 99%

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

et al. 2019

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“…3,4 Over the past decade, the scientific literature has brought increased attention to the risks football players face for sustaining an SRC and the possible development of depression and neurocognitive changes later in life. [5][6][7] This increased focus has been amplified by reports in the lay press that cited examples of significant disablement among football players who sustained SRCs. 8 Beyond the initial restriction from sport, many stakeholders have ongoing concerns regarding short-term and long-term disablement associated with SRCs.…”

mentioning

confidence: 99%

A Prospective Study of Concussions and Health Outcomes in High School Football Players

McGuine

Pfaller²,

Hetzel

et al. 2020

Journal of Athletic Training

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Context Football is the most popular sport among US high school students and among the highest for sport-related concussion (SRC) incidence. Limited data detail how SRCs affect high school football players' psychosocial and health status beyond short-term injury recovery. Objective To longitudinally assess how SRCs affected symptoms, depression, and health-related quality of life (HRQoL) in high school football players up to 12 months after SRC. Design Prospective cohort study. Setting Thirty-one Wisconsin high schools. Patients or Other Participants A total of 176 interscholastic football players (age = 16.0 ± 1.2 years). Main Outcome Measure(s) Participants completed the Postconcussion Symptom Scale (PCSS) from the Sport Concussion Assessment Tool 3 (SCAT3), Patient Health Questionnaire-9 (PHQ-9) for depression, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for HRQoL at enrollment. Participants who sustained an SRC repeated each measure within 72 hours of their injury (onset) and at 7 days (D7), return to play (RTP), 3 months (M3), 6 months (M6), and 12 months (M12) after SRC. Scores at each time point were compared with each participant's baseline using linear mixed models for repeated measures whilecontrolling for age and previous SRC with participant as a random effect. Results Sixty-two participants sustained an SRC. Participants reported a higher number of PCSS symptoms, greater symptom severity, and lower PedsQL physical summary scores at onset and D7. From RTP through M12, PCSS symptoms, PCSS severity scores, PedsQL total scores, physical summary, and psychosocial summary were unchanged or improved relative to baseline. The PHQ-9 scores were not higher than baseline at any post-SRC interval. Conclusions High school football players in this study who sustained an SRC described no sustained adverse health outcomes (increased PCSS symptoms or symptom severity, increased depression symptoms, or lower HRQoL) after their RTP through M12 after injury.

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“…F ootball players have one of the highest injury rates at both the collegiate and high school (HS) levels, [1][2][3] likely due to legal contact being allowed during gameplay. Although much of the focus on football injuries has been on concussion 4,5 and other potentially catastrophic conditions, such as cervical spine injuries, [6][7][8] less severe injuries such as cervical muscle strains are not often discussed.…”

mentioning

confidence: 99%

Epidemiology of Cervical Muscle Strains in Collegiate and High School Football Athletes, 2011–2012 Through 2013–2014 Academic Years

Lee

Kay

Kucera

et al. 2019

Journal of Athletic Training

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Context Cervical muscle strains are an often-overlooked injury, with neck- and spine-related research typically focusing on spinal cord and vertebral injuries. Objective To examine the rates and distributions of cervical muscle strains in collegiate and high school football athletes. Design Descriptive epidemiology study. Setting Collegiate and high school football teams. Patients or Other Participants The National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) collected data from collegiate football athletes. The High School National Athletic Treatment, Injury and Outcomes Network (HS NATION) and High School Reporting Information Online (HS RIO) collected data from high school football athletes. Data from the 2011–2012 through 2013–2014 academic years were used. Main Outcome Measure(s) Athletic trainers collected injury and exposure data for football players. Injury counts, injury rates per 10 000 athlete-exposures (AEs), and injury rate ratios with 95% confidence intervals (CIs) were calculated. Results The NCAA-ISP reported 49 cervical muscle strains (rate = 0.96/10 000 AEs), of which 28 (57.1%) were TL (time loss; rate = 0.55/10 000 AEs). High School NATION reported 184 cervical muscle strains (rate = 1.66/10 000 AEs), of which 33 (17.9%) were TL injuries (rate = 0.30/10 000 AEs). The HS RIO, which collects only TL injuries, reported 120 TL cervical muscle strains (rate = 0.51/10 000 AEs). The overall injury rate was lower in the NCAA-ISP than in HS NATION (injury rate ratio = 0.58; 95% CI = 0.42, 0.79); when restricted to TL injuries, the overall injury rate was higher in the NCAA-ISP (injury rate ratio = 1.83; 95% CI = 1.11, 3.03). No differences were found when comparing TL injuries in HS RIO and the NCAA-ISP. Cervical muscle-strain rates were higher during competitions than during practices across all 3 surveillance systems for all injuries. Most cervical muscle strains were due to player contact (NCAA-ISP = 85.7%, HS NATION = 78.8%, HS RIO = 85.8%). Conclusions The incidence of cervical muscle strains in football players was low compared with other injuries. Nonetheless, identifying and implementing interventions, particularly those aimed at reducing unsafe player contact, are essential to further decrease the risk of injury and associated adverse outcomes.

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Association Between History of Multiple Concussions and Health Outcomes Among Former College Football Players: 15-Year Follow-up From the NCAA Concussion Study (1999-2001)

Cited by 65 publications

References 42 publications

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

A Prospective Study of Concussions and Health Outcomes in High School Football Players

Epidemiology of Cervical Muscle Strains in Collegiate and High School Football Athletes, 2011–2012 Through 2013–2014 Academic Years

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