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Background: Current medical practices and recommendations largely ignore the safety of postconcussion driving, even though commonly used measures of neurocognition, balance, and vestibulo-ocular function show impairment. Purpose: To compare simulated driving between patients with concussion and controls throughout concussion recovery using a case-control design. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 26 concussed and 23 control Division I collegiate athletes completed a driving simulation assessment at 3 time points (within 72 hours, asymptomatic, and return to sport). Cumulative driving simulation outcome variables included total number of collisions, speed exceedances, stop signs missed, lane excursions, total drive time, percentage of time over the speed limit, and percentage of time out of the lane. The mean speed, standard deviation of speed (SDS), lateral lane position, and standard deviation of lateral lane position (SDLP) were examined for each of the 11 drive segments. Outcomes were compared using generalized linear mixed models with random intercepts by participant with Poisson or normal distributions. Results: Within 72 hours of injury, the concussion group committed more lane excursions (median difference, 2; P =.003), exhibited greater SDS while avoiding a child pedestrian crossing the road (Cohen d = 0.73; P =.011), drove ~7 inches (~18 cm) closer to the centerline during a residential left curve (d = 0.90; P =.015), and had greater SDLP while navigating around a car crash compared with controls (d = 0.72; P =.016). When asymptomatic, the concussion group committed fewer speed exceedances (median difference, 2; P =.002) and had lower SDLP while navigating through a traffic light compared with controls (d = 0.60; P =.045). No differences were evident at return to sport. Groups did not differ in total collisions at any time point. Conclusion: The concussion group showed more impaired driving patterns within 72 hours of injury, drove more conservatively once asymptomatic, and had similar driving performance at the time they returned fully to sport. Clinicians should consider these findings when discussing driving with patients acutely after concussion. Further research is needed to determine whether on-road collision risk is elevated after concussion. [ABSTRACT FROM AUTHOR]

Background: Youth flag football participation has rapidly grown and is a potentially safer alternative to tackle football. However, limited research has quantitatively assessed youth flag football head impact biomechanics. Purpose: To describe head impact biomechanics outcomes in youth flag football and explore factors associated with head impact magnitudes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We monitored 52 player-seasons among 48 male flag football players (mean ± SD; age, 9.4 ± 1.1 years; height, 138.6 ± 9.5 cm; mass, 34.7 ± 9.2 kg) across 3 seasons using head impact sensors during practices and games. Sensors recorded head impact frequencies, peak linear (g) and rotational (rad/s2) acceleration, and estimated impact location. Impact rates (IRs) were calculated as 1 impact per 10 player-exposures; IR ratios (IRRs) were used to compare season, event type, and age group IRs; and 95% CIs were calculated for IRs and IRRs. Weekly and seasonal cumulative head impact frequencies and magnitudes were calculated. Mixed-model regression models examined the association between player characteristics, event type, and seasons and peak linear and rotational accelerations. Results: A total of 429 head impacts from 604 exposures occurred across the study period (IR, 7.10; 95% CI, 4.81-10.50). Weekly and seasonal cumulative median head impact frequencies were 1.00 (range, 0-2.63) and 7.50 (range, 0-21.00), respectively. The most frequent estimated head impact locations were the skull base (n = 96; 22.4%), top of the head (n = 74; 17.2%), and back of the head (n = 66; 15.4%). The combined event type IRs differed among the 3 seasons (IRR range, 1.45-2.68). Games produced greater IRs (IRR, 1.24; 95% CI, 1.01-1.53) and peak linear acceleration (mean difference, 5.69 g; P =.008) than did practices. Older players demonstrated greater combined event–type IRs (IRR, 1.46; 95% CI, 1.12-1.90) and increased head impact magnitudes than did younger players, with every 1-year age increase associated with a 3.78 g and 602.81-rad/s2 increase in peak linear and rotational acceleration magnitude, respectively (P ≤.005). Conclusion: Head IRs and magnitudes varied across seasons, thus highlighting multiple season and cohort data are valuable when providing estimates. Head IRs were relatively low across seasons, while linear and rotational acceleration magnitudes were relatively high. [ABSTRACT FROM AUTHOR]