Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes .
Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes .
Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported .
Background Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years .
Our objective is to conduct a prospect ively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions .
Helmets for preventing head and facial injuries in bicyclists.
BACKGROUND : Each year , in the United states , approximately 900 persons die from injuries due to bicycle crashes and over 500,000 persons are treated in emergency departments . Head injury is by far the greatest risk posed to bicyclists , comprising one-third of emergency department visits , two-thirds of hospital admissions , and three-fourths of deaths . Facial injuries to cyclists occur at a rate nearly identical to that of head injuries . Although it makes inherent sense that helmets would be protective against head injury , establishing the real-world effectiveness of helmets is important . A number of case-control studies have been conducted demonstrating the effectiveness of bicycle helmets . Because of the magnitude of the problem and the potential effectiveness of bicycle helmets , the objective of this review is to determine whether bicycle helmets reduce head , brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall . OBJECTIVES : To determine whether bicycle helmets reduce head , brain and facial injury for bicyclists of all ages involved in a bicycle crash or fall . SEARCH STRATEGY : We search ed The Cochrane Controlled Trials Register , MEDLINE , EMBASE , Sport , ERIC , NTIS , Exp and ed Academic Index , CINAHL , PsycINFO , Occupational Safety and Health , and Dissertations Abstract s. We checked reference lists of past review s and review articles , studies from government agencies in the United States , Europe and Australia , and contacted colleagues from the International Society for Child and Adolescent Injury Prevention , World Injury Network , CDC funded Injury Control and Research Centers , and staff in injury research agencies around the world . SELECTION CRITERIA : Controlled studies that evaluated the effect of helmet use in a population of bicyclists who had experienced a crash . We required that studies have complete outcome ascertainment , accurate exposure measurement , appropriate selection of the comparison group and elimination or control of factors such as selection bias , observation bias and confounding . DATA COLLECTION AND ANALYSIS : Five published studies met the selection criteria . Two abstract ors using a st and ard abstract ion form independently abstract ed data . Odds ratios with 95 % CI were calculated for the protective effect of helmet for head and facial injuries . Study results are presented individually . Head and brain injury results were also summarized using meta- analysis techniques . MAIN RESULTS : No r and omized controlled trials were found . This review identified five well conducted case control studies which met our selection criteria . Helmets provide a 63%-88 % reduction in the risk of head , brain and severe brain injury for all ages of bicyclists .  Helmets provide equal levels of protection for crashes involving motor vehicles ( 69 % ) and crashes from all other causes ( 68 % ) . Injuries to the upper and mid facial areas are reduced 65 % . REVIEW ER 'S CONCLUSIONS : Helmets reduce bicycle-related head and facial injuries for bicyclists of all ages involved in all types of crashes including those involving motor vehicles
Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes .
Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes .
Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported .
Background Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years .
Our objective is to conduct a prospect ively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions .