Frequency of Head-Impact–Related Outcomes by Position in NCAA Division I Collegiate Football Players
Abstract
Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and “dings” (p<0.001); offensive linemen reported significantly higher numbers than most other positions. Significant differences were found between position groups in the frequencies of several postimpact symptoms, including dizziness (p<0.001), headache (p<0.001), and seeing stars (p<0.001) during the 2012 football season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion.
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Copyright 2015, Mary Ann Liebert, Inc.
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Published in print: March 1, 2015
Published ahead of print: 16 December 2014
Published online: 26 August 2014
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Christine M. Baugh received funding from the Edmond J. Safra Center for Ethics at Harvard University to conduct the larger study from which data for this manuscript was derived. Emily Kroshus receives funding from the NCAA Sports Science Institute as a postdoctoral research fellow. Robert A. Stern is a paid consultant to Athena Diagnostics and receives royalties from Psychological Assessment Resources, Inc. He also provides expert consultation to legal teams involved with NCAA and NFL-related litigation.
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