title: Examining concussion rates and return to play in high school football players wearing newer helmet technology: a three-year prospective cohort study.
abstract: OBJECTIVE
  The purpose of this study was to compare concussion rates and recovery times for athletes wearing newer helmet technology compared to traditional helmet design.
  
  
  METHODS
  This was a three-year, prospective, naturalistic, cohort study. Participants were 2,141 high school athletes from Western Pennsylvania. Approximately half of the sample wore the Revolution helmet manufactured by Riddell, Inc. (n = 1,173) and the remainder of the sample used standard helmets (n = 968). Athletes underwent computerized neurocognitive testing through the use of ImPACT at the beginning of the study. Following a concussion, players were reevaluated at various time intervals until recovery was complete.
  
  
  RESULTS
  In the total sample, the concussion rate in athletes wearing the Revolution was 5.3% and in athletes wearing standard helmets was 7.6% [chi (1, 2, 141) = 4.96, P < 0.027]. The relative risk estimate was 0.69 (95% confidence interval = 0.499- 0.958). Wearing the Revolution helmet was associated with approximately a 31% decreased relative risk and 2.3% decreased absolute risk for sustaining a concussion in this cohort study. The athletes wearing the Revolution did not differ from athletes wearing standard helmets on the mechanism of injury (e.g., head-to-head strike), on-field concussion markers (e.g., amnesia or loss of consciousness), or on-field presentation of symptoms (e.g., headaches, dizziness, or balance problems).
  
  
  CONCLUSIONS
  Recent sophisticated laboratory research has better elucidated injury biomechanics associated with concussion in professional football players. This data has led to changes in helmet design and new helmet technology, which appears to have beneficial effects in reducing the incidence of cerebral concussion in high school football players.
authors.affiliation: University of Pittsburgh Medical Center Sports Concussion Program, Department of Orthopaedic Surgery/University of Pittsburgh Medical Center for Sports Medicine, Pennsylvania 15206, USA. collinsmw@upmc.edu
authors.forename: Micky
authors.initials: M
authors.lastname: Collins
authors.forename: Mark R
authors.initials: MR
authors.lastname: Lovell
authors.forename: Grant L
authors.initials: GL
authors.lastname: Iverson
authors.forename: Thad
authors.initials: T
authors.lastname: Ide
authors.forename: Joseph
authors.initials: J
authors.lastname: Maroon
mesh_terms: D000293:Adolescent; D000328:Adult; D001924:Brain Concussion / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D005538:Football / Q000293:injuries*; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010414:Pennsylvania; D011446:Prospective Studies; D020127:Recovery of Function; D013334:Students