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 .
Risk of injury associated with body checking among youth ice hockey players.
CONTEXT Ice hockey has one of the highest sport participation and injury rates in youth in Canada .  Body checking is the predominant mechanism of injury in leagues in which it is permitted . OBJECTIVE To determine if risk of injury and concussion differ for Pee Wee ( ages 11 - 12 years ) ice hockey players in a league in which body checking is permitted ( Alberta , Canada ) vs a league in which body checking is not permitted ( Quebec , Canada ) . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study conducted in Alberta and Quebec during the 2007 - 2008 Pee Wee ice hockey season . Participants ( N = 2154 ) were players from teams in the top 60 % of divisions of play . MAIN OUTCOME MEASURES Incidence rate ratios adjusted for cluster based on Poisson regression for game- and practice -related injury and concussion . RESULTS Seventy-four Pee Wee teams from Alberta ( n = 1108 players ) and 76 Pee Wee teams from Quebec ( n = 1046 players ) completed the study . In total , there were 241 injuries ( 78 concussions ) reported in Alberta ( 85 077 exposure-hours ) and 91 injuries ( 23 concussions ) reported in Quebec ( 82 099 exposure-hours ) . For game-related injuries , the Alberta vs Quebec incidence rate ratio was 3.26 ( 95 % confidence interval [ CI ] , 2.31 - 4.60 [ n = 209 and n = 70 for Alberta and Quebec , respectively ] ) for all injuries , 3.88 ( 95 % CI , 1.91 - 7.89 [ n = 73 and n = 20 ] ) for concussion , 3.30 ( 95 % CI , 1.77 - 6.17 [ n = 51 and n = 16 ] ) for severe injury ( time loss , > 7 days ) , and 3.61 ( 95 % CI , 1.16 - 11.23 [ n=14 and n=4 ] ) for severe concussion ( time loss , > 10 days ) . The estimated absolute risk reduction ( injuries per 1000 player-hours ) that would be achieved if body checking were not permitted in Alberta was 2.84 ( 95 % CI , 2.18 - 3.49 ) for all game-related injuries , 0.72 ( 95 % CI , 0.40 - 1.04 ) for severe injuries , 1.08 ( 95 % CI , 0.70 - 1.46 ) for concussion , and 0.20 ( 95 % CI , 0.04 - 0.37 ) for severe concussion . There was no difference between provinces for practice -related injuries . CONCLUSION Among 11- to 12-year-old ice hockey players , playing in a league in which body checking is permitted compared with playing in a league in which body checking is not permitted was associated with a 3-fold increased risk of all game-related injuries and the categories of concussion , severe injury , and severe concussion
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 .