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Context: Whereas researchers have provided estimates for the number of head impacts sustained within a youth football season, less is known about the number of plays across which such impact exposure occurs. Objective: To estimate the number of plays in which youth football players participated during the 2013 season and to estimate injury incidence through play-based injury rates. Design: Descriptive epidemiology study. Setting: Youth football. Patients or Other Participants: Youth football players (N = 2098; age range, 5-15 years) from 105 teams in 12 recreational leagues across 6 states. Main Outcome Measure(s): We calculated the average number of athlete-plays per season and per game using independent-samples t tests to compare age groups (5-10 years old versus 11-15 years old) and squad sizes (,20 versus <20 players); game injury rates per 1000 athlete-exposures (AEs) and per 10 000 athlete-plays; and injury rate ratios (IRRs) with 95% confidence intervals (CIs) to compare age groups. Results: On average, youth football players participated in 333.9 6 178.5 plays per season and 43.9 6 24.0 plays per game. Age groups (5- to 10-year-olds versus 11- to 15-yearolds) did not differ in the average number of plays per season (335.8 versus 332.3, respectively; t2086.4 = 0.45, P = .65) or per game (44.1 versus 43.7, respectively; t2092.3 = 0.38, P = .71). However, players from smaller teams participated in more plays per season (373.7 versus 308.0; t1611.4 = 8.15, P < .001) and per game (47.7 versus 41.4; t1523.5 = 5.67, P < .001). Older players had a greater game injury rate than younger players when injury rates were calculated per 1000 AEs (23.03 versus 17.86/1000 AEs; IRR=1.29; 95% CI=1.04, 1.60) or per 10 000 athlete-plays (5.30 versus 4.18/10 000 athlete-plays; IRR=1.27; 95% CI = 1.02, 1.57). Conclusions: A larger squad size was associated with a lower average number of plays per season and per game. Increasing youth football squad sizes may help reduce headimpact exposure for individual players. The AE-based injury rates yielded effect estimates similar to those of play-based injury rates. [ABSTRACT FROM AUTHOR]

Context: Sports participation is one of the leading causes of concussions among nearly 8 million US high school student-athletes. Objective: To describe the epidemiology of sport-related concussion (SRC) in 27 high school sports during the 2011- 2012 through 2013-2014 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data from 27 sports in 147 high schools in the National Athletic Treatment, Injury and Outcomes Network (NATION). Patients or Other Participants: Boy and girl high school athletes during the 2011-2012 through 2013-2014 academic years. Main Outcome Measure(s): Sport-related concussion counts, percentages, rates per 10 000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios (IPRs) were reported with 95% confidence intervals (CIs). Rate ratios and IPRs with 95% CIs not containing 1.0 were considered significant. Results: Overall, 2004 SRCs were reported among 27 high school sports, for a rate of 3.89 per 10 000 AEs. Football had the highest SRC rate (9.21/10 000 AEs), followed by boys' lacrosse (6.65/10 000 AEs) and girls' soccer (6.11/10 000 AEs). The SRC rate was higher in competition than in practice (RR = 3.30; 95% CI = 3.02, 3.60). Among sex-comparable sports, the SRC rate was higher in girls than in boys (RR=1.56; 95% CI=1.34, 1.81); however, the proportion of SRCs due to player-to-player contact was higher in boys than in girls (IPR = 1.48; 95% CI = 1.27, 1.73). Common symptoms reported among all athletes with SRCs were headache (94.7%), dizziness (74.8%), and difficulty concentrating (61.0%). Only 0.8% of players with SRCs returned to play within 24 hours. The majority of athletes with SRCs (65.8%) returned to play between 7 and 28 days. More players had symptoms resolve after 7 days (48.8%) than less than a week (40.7%). Conclusions: Our findings provide updated high school SRC incidence estimates and further evidence of sex differences in reported SRCs. Few athletes with SRCs returned to play within 24 hours or a week. Most injured players returned after 7 days, despite a smaller proportion having symptoms resolve within a week. [ABSTRACT FROM AUTHOR]