title: Epidemiology of Sport-Related Concussion in an NCAA Division I Football Bowl Subdivision Sample.
abstract: Concussions are common in football, and knowledge of their incidence rates across settings is needed to develop strategies to decrease occurrence.
  
  
  
  To examine sports-related concussion rates in a National Collegiate Athletic Association (NCAA) Division I Football Bowl Subdivision sample based on the activity setting where injuries occurred, during which type of play, and when relative to the 2010 NCAA concussion management policy.
  
  
  
  Descriptive epidemiology study.
  
  
  
  Medical records from January 2006 to January 2015 for an NCAA Division I Football Bowl Subdivision program were analyzed. Concussion rates (per 1000 athlete-exposures [AEs]) were compared among the following settings: spring practice, preseason training camp, regular season high-contact practice, regular season low-contact practice, bowl game practice, and game competition. Play-type analyses examined incidence rates during offensive, defensive, and special teams plays. Changes in concussion rate coinciding with the 2010 NCAA concussion management policy were also studied.
  
  
  
  Of the 452 unique players on the roster during the 9-year study period, 118 (26.1%) were diagnosed with a concussion. The concussion rate during games was significantly higher than all practices combined (P < .001). However, when game rate (4.46 per 1000 AEs) was compared with preseason training camp alone (3.81 per 1000 AEs), there was no significant difference (P = .433). The concussion rate during special teams plays was significantly higher than that during offensive (P < .001) or defensive plays (P < .001). The concussion rate in the 4 seasons (2010-2014) after the 2010 NCAA concussion management policy was initiated was significantly higher than the 4 seasons (2006-2009) preceding the policy (P = .036).
  
  
  
  Study results show that (1) based on activity type, games and preseason training camp present the greatest risk of sustaining a concussion; (2) based on play type, special teams plays pose the greatest risk of sustaining a concussion; and (3) the 2010 NCAA concussion management policy coincided with a significant increase in recognition of concussion.
authors.affiliation: University of Florida, Gainesville, Florida, USA zhouck@phhp.ufl.edu.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Houck
authors.affiliation: University of Florida, Gainesville, Florida, USA.
authors.forename: Breton
authors.initials: B
authors.lastname: Asken
authors.affiliation: University of Florida, Gainesville, Florida, USA.
authors.forename: Russell
authors.initials: R
authors.lastname: Bauer
authors.affiliation: University of Florida, Gainesville, Florida, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Pothast
authors.affiliation: University of Florida, Gainesville, Florida, USA.
authors.forename: Charlie
authors.initials: C
authors.lastname: Michaudet
authors.affiliation: University of Florida, Gainesville, Florida, USA.
authors.forename: James
authors.initials: J
authors.lastname: Clugston
mesh_terms: D000293:Adolescent; D056352:Athletes; D001924:Brain Concussion / Q000453:epidemiology* / Q000209:etiology; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D008297:Male; D012621:Seasons; D013334:Students; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: concussion; epidemiology; football; incidence rate