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 .
The impact of face shield use on concussions in ice hockey: a multivariate analysis
Objective : To identify specific risk factors for concussion severity among ice hockey players wearing full face shields compared with half face shields ( visors ) .  Methods : A prospect i ve cohort study was conducted during one varsity hockey season ( 1997–1998 ) with 642 male ice hockey players ( median age 22 years ) from 22 teams participating in the Canadian Inter-University Athletics Union . Half of the teams wore full face shields , and half wore half shields ( visors ) for every practice and game throughout the season . Team therapists and doctors recorded on structured forms daily injury , participation , and information on face shield use for each athlete . The main outcome measure was any traumatic brain injury requiring assessment or treatment by a team therapist or doctor , categorised by time lost from subsequent participation and compared by type of face shield worn . Results : Players who wore half face shields missed significantly more practice s and games per concussion ( 2.4 times ) than players who wore full face shields ( 4.07 sessions ( 95 % confidence interval ( CI ) 3.48 to 4.74 ) v 1.71 sessions ( 95 % CI 1.32 to 2.18 ) respectively ) . Significantly more playing time was lost by players wearing half shields during practice s and games , and did not depend on whether the athletes were forwards or defence , rookies or veterans , or whether the concussions were new or recurrent . In addition , players who wore half face shields and no mouthguards at the time of concussion missed significantly more playing time ( 5.57 sessions per concussion ; 95 % CI 4.40 to 6.95 ) than players who wore half shields and mouthguards ( 2.76 sessions per concussion ; 95 % CI 2.14 to 3.55 ) . Players who wore full face shields and mouthguards at the time of concussion lost no playing time compared with 1.80 sessions lost per concussion ( 95 % CI 1.38 to 2.34 ) for players wearing full face shields and no mouthguards . Conclusions : The use of a full face shield compared with half face shield by intercollegiate ice hockey players significantly reduced the playing time lost because of concussion , suggesting that concussion severity may be reduced by the use of a full face shield
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 .