Game-Related Impacts in High School Boys' Lacrosse.

MedStar author(s):
Citation: Orthopaedic Journal of Sports Medicine. 7(4):2325967119835587, 2019 Apr.PMID: 31058198Institution: MedStar Health Research Institute | MedStar Union Memorial HospitalDepartment: MedStar Sports Medicine | Sports Medicine Research CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2019ISSN:
  • 2325-9671
Name of journal: Orthopaedic journal of sports medicineAbstract: Background: The rate of concussions in boys' lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys' lacrosse players.Conclusion: The helmet is commonly used to initiate contact in boys' high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.Methods: A total of 77 male participants (mean age, 16.6 +/- 1.2 years; mean height, 1.77 +/- 0.05 m; mean weight, 73.4 +/- 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts >=20g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated.Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys' varsity high school lacrosse.Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision.Study Design: Cross-sectional study; Level of evidence, 3.All authors: Caswell SV, Cortes N, Dunn R, Hepburn L, Kelshaw P, Lincoln AEFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-05-21
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Journal Article MedStar Authors Catalog Article 31058198 Available 31058198

Background: The rate of concussions in boys' lacrosse is reported to be the third highest among high school sports in the United States, but no studies have described game-related impacts among boys' lacrosse players.

Conclusion: The helmet is commonly used to initiate contact in boys' high school lacrosse, often targeting defenseless opponents. Interventions to reduce head impacts should address rules and coaching messages to discourage intentional use of the helmet and encourage protection of defenseless opponents.

Methods: A total of 77 male participants (mean age, 16.6 +/- 1.2 years; mean height, 1.77 +/- 0.05 m; mean weight, 73.4 +/- 12.2 kg) were instrumented with sensors and were videotaped during 39 games. All verified game-related impacts >=20g were summarized in terms of frequency, peak linear acceleration (PLA), and peak rotational velocity (PRV). Descriptive statistics and impact rates per player-game (PG) with corresponding 95% CIs were calculated.

Purpose: To characterize verified game-related impacts, both overall and those directly to the head, in boys' varsity high school lacrosse.

Results: Overall, 1100 verified game-related impacts were recorded (PLA: median, 33.5g [interquartile range (IQR), 25.7-51.2]; PRV: median, 1135.5 deg/s [IQR, 790.0-1613.8]) during 795 PGs. The rate for all verified game-related impacts was 1.38 impacts per PG (95% CI, 1.30-1.47). Of these, 680 (61.8%) impacts (PLA: median, 35.9g [IQR, 26.7-55.5]; PRV: 1170.5 deg/s [IQR, 803.2-1672.8]) were directly to the head (impact rate, 0.86 impacts/PG [95% CI, 0.79-0.92]). Overall, midfielders (n = 514; 46.7%) sustained the most impacts, followed by attackers (n = 332; 30.2%), defenders (n = 233; 21.2%), and goalies (n = 21; 1.9%). The most common mechanisms for overall impacts and direct head impacts were contact with player (overall: n = 706 [64.2%]; head: n = 397 [58.4%]) and stick (overall: n = 303 [27.5%]; head: n = 239 [35.1%]), followed by ground (overall: n = 73 [6.6%]; head: n = 26 [3.8%]) and ball (overall: n = 15 [1.4%]; head: n = 15 [2.2%]). Direct head impacts were associated with a helmet-to-helmet collision 31.2% of the time, and they were frequently (53.7%) sustained by the players delivering the impact. Nearly half (48.8%) of players delivering contact used their helmets to initiate contact that resulted in a helmet-to-helmet impact. Players receiving a head impact from player contact were most often unprepared (75.9%) for the collision.

Study Design: Cross-sectional study; Level of evidence, 3.

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