The effect of concussion on subsequent lower injury in current NFL players
Date
2018
Authors
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Journal ISSN
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Publisher
University of Delaware
Abstract
Context: Recent literature suggests individuals may be at an elevated risk for sustaining a subsequent injury following return to play from sport related concussion (SRC). National Football League athletes are underrepresented in this literature, and as football has one of the highest concussion incidence rates in sport, it is important to examine the relationship between concussion and musculoskeletal (MSK) injuries in this cohort. ☐ Objective: The first aim of this project was to assess the association and risk of lower extremity musculoskeletal injury (LEMSK) both prior and after concussion between team and position-matched players who sustained an SRC and players who did not during the same season. The second aim of this study was to examine the association and risk of LEMSK following concussion of position-matched players who sustained an SRC and those who sustained an injury that was non-lower extremity. ☐ Design: Cohort study ☐ Setting: Publicly available NFL injury report data. ☐ Patients or Other Participants: NFL athletes ☐ Main Outcome Measure(s): The concussion rate and the rate of LEMSK pre and post-concussion. ☐ Results: Chi square analysis showed no association between concussion and LEMSK post-concussion (x2 = 2.19, p = 0.17) for Aim 1 (concussed vs. non-concussed player/team matched controls) or Aim 2 (x2 = 2.58, p=0.13) (concussed vs non-concussed and non-LEMSK). There was a significant association between concussion and LEMSK during the pre-concussion time period (x2=15.22, p<.001) between players who sustained a concussion and those that did not. Odds ratio pre-concussion was 0.52 (95% CI: 0.37- 0.72), where the control group was more likely to sustain a LEMSK. For Aim1, the Cox proportional hazard model showed no significance for groups post-concussion, but statistical significance was identified pre-concussion (p<.001) where prior to sustaining a concussion, the non-concussed players were 1.72 times more likely to sustain a LEMSK than the concussed group. For Aim 2, the Cox model was not significant (p=0.14). ☐ Conclusion: Concussion did not increase the likelihood of appearing on the NFL injury report for LEMSK pre or post-concussion in NFL players. Both players with and without concussions are about at equal risk to sustain a LEMSK post-concussion, and players who did not go on to sustain a concussion were more likely to sustain a LEMSK than those who sustained a concussion prior to the concussion event. Players that sustained a non-LEMSK injury prior to their matches’ concussion week also did not show an increased risk to appear on the NFL injury report with a LEMSK compared to the concussed group.
Description
Keywords
Health and environmental sciences, Concussion, NFL, Subsequent injury