Introduction: Sport-Related Concussion (SRC) is caused by a strong impact to the head that leads to neurological symptoms. Within the sporting community it is a widely held belief that Headgear (HG) protects against SRC leading some Australian football, soccer, and rugby clubs to mandate its use. The aim of this study was to evaluate the effectiveness of HG in reducing the incidence of SRC among athletes.
Methods: This systematic review with meta-analysis was based upon the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search for relevant studies published from 1985-2022 using the following databases: Cochrane Library, MEDLINE, AMED, PubMed, Web of Science, and PEDro was conducted. The keywords used in the search strategy were ‘Headgear’, ‘Sport-Related Concussion’, ‘head injury’, ‘athlete’, and variations of these search terms. Included studies had to be randomized controlled trials using HG for athletes with the primary outcome being SRC rate. There were no restrictions of age or playing level. The random-effects model by the RevMan Meta-Analysis software (version 5) was used in analysing the extracted data.
Results: The pooled results of 6311 athletes and 173383 exposure hours showed 0% SRC reduction per 1000 hours of exposure in the intervention group compared to the control group with an injury risk ratio [IRR] of 1.03 (95% confidence interval [CI] 0.82–1.30, P=0.79).
Discussion/Conclusion: This is the first meta-analysis of randomized controlled trials to evaluate the effectiveness of HG in reducing the incidence of SRC among athletes. The results showed no SRC reduction when soccer or rugby players wearing HG during their practice.
Impact/Application to the field: Players wearing HG may play more aggressively due to the feeling that the added head protection limits risk of injury. This meta-analysis demonstrates that HG does not prevent SRC among athletes and therefore the findings from this meta-analysis does not support the use of HG to prevent SRC in soccer or rugby.
Conflict of interest statement: No conflict of interest of relevance to the submission of this abstract.