Sports-Related Concussion in Helmeted vs. Unhelmeted Athletes: Who Fares Worse?

Abstract

In the management of sports-related concussion, little is known about the effect of wearing or not wearing a helmet (i. e., helmet status) on the acute outcomes of concussed athletes. We endeavored to assess acute neurocognitive and symptom changes after SRC in helmeted vs. unhelmeted athletes. In a retrospective study, 1 025 athletes from 2 regional databases sustained a SRC. Athletes were matched by age, gender, number of prior concussions, and days to post-concussion test, yielding a final cohort of 138 athletes. For each group of 69, differences in post-concussion neurocognitive and symptom scores were compared using group mean differences as well as reliable change index (RCI) scores set at the 80% confidence interval. With gender, prior concussions, and days to post-concussion test similar in each group, using group mean change scores and RCI methodology, we found no significant differences between the helmeted and unhelmeted groups in 4 neurocognitive tests and one total symptom score. In a cohort of carefully matched athletes from 2 regional concussion centers, helmet status was unrelated to neurocognitive scores and total symptoms in athletes after suffering a SRC. These findings suggest that acute outcomes in helmeted vs. unhelmeted sports are quite similar.

Predictors of postconcussion syndrome in collegiate student-athletes

“…45 All those studies were conducted in a general population, and most were in children and adolescents who presented to the emergency department. Also, although 1 previous study identified helmeted versus unhelmeted status as a predictor of acute outcome after SRC, 53 we did not find helmet status to be associated with PCS. Although most media attention surrounds collision sports such as football and hockey, contact level did not predict PCS in our cohort.…”

“…41,44 Helmet status was determined as previously described, and those sports played partly with helmets were included in the helmeted group, except when only the goalie was helmeted. 53 Recurrent SRC was defined as more than 1 SRC suffered during the studentathlete's participation in the ISP. A comprehensive list of 17 symptoms was used.…”

Padded Headgear does not Reduce the Incidence of Match Concussions in Professional Men’s Rugby Union: A Case-control Study of 417 Cases

“…The finding that the use of headgear that is permitted by the international governing body was not associated with concussion is in agreement with intervention studies in rugby union [13,14]. Fur-thermore, there was no difference between wearing and not wearing headgear in terms of the number of days missed following concussion, which supports previous findings of similar acute concussion outcomes in helmeted and unhelmeted sports [24]. The primary purpose of padded headgear is to prevent abrasions and lacerations, with evidence of reduced damage to the scalp and ears when wearing headgear [12].…”

Comparing fMRI activation during smooth pursuit eye movements among contact sport athletes, non-contact sport athletes, and non-athletes

“…No cross-country runners were diagnosed with a concussion while at IU. In general sport related head impacts in cross-country are extremely rare and the lowest of all the NCAA sanctioned sports ( Zuckerman et al, 2015 ). It should also be noted some football players may have received a diagnosed concussion in high school, and others may have successfully hidden prior concussions from the medical staff of either high school, college, or both.…”