Abstract
Abstract Objective Middle school is often the first exposure to American football for many children. However, research examining concussion in football has primarily focused on high school and older athletes. Therefore, we investigated the incidence of concussion and subsequent sport time loss (TL) in MS football. Methods Athlete exposure (AE) and injury rates (IR) were gathered by onsite Certified Athletic Trainers within public middle school for all events across the 2015/16–2019/20 school years. AE was defined as one athlete participating in one practice or game. TL was defined as the number of days between the injury and return to sport dates. Concussion rates per 1000AE with corresponding confidence intervals (CI) were calculated. Injury rate ratios (IRR) with 95% CIs were compared IR between practices and games. CIs excluding 1.0 were considered significant. Results 75 concussions (IR = 1.38/1000AE, 95% CI = 1.06–1.69) occurred across 54,544 AEs. The concussion rate was significantly higher in games (n = 31, IR = 3.51, 95%CI = 2.27–4.75) than practices (n = 44, IR = 0.96, 95%CI = 0.68–1.25; IRR = 3.65, 95%CI = 2.30–5.77). The mean sport TL was 16.50 ± 8.25 days. Conclusions We observed middle school football concussion rates (practices and games) and associated TL from sport to be consistent with prior youth and high school football research. However, the concussion rate for middle school games was more than 3 times that of practices. This is similar to prior middle school football findings, but less than reported in high school football. Continued research evaluating modifiable risk factors for concussion in middle school football games and practices is needed.
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