{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:12:36Z","timestamp":1792818756909,"version":"4.5.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012676","name":"National Collegiate Athletic Association","doi-asserted-by":"publisher","award":["MD 21702\u00c2?5014"],"award-info":[{"award-number":["MD 21702\u00c2?5014"]}],"id":[{"id":"10.13039\/100012676","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The Concussion Assessment, Research and Education (CARE) Consortium database was used. The mechanism of injury was categorized into head-to-ball, head-to-head, head-to-body, and head-to-ground\/equipment. Baseline\/acute injury characteristics\u2014including Sports Concussion Assessment Tool\u20133 total symptom severity (TSS), loss of consciousness (LOC), and altered mental status (AMS); descriptive data; and recovery (RTP and URTP)\u2014were compared. Multivariable regression and Weibull models were used to assess the predictive value of the mechanism of injury on TSS and RTP\/URTP, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 391 soccer SRCs, 32.7% were attributed to a head-to-ball mechanism, 27.9% to a head-to-body mechanism, 21.7% to a head-to-head mechanism, and 17.6% to a head-to-ground\/equipment mechanism. Event type was significantly associated with injury mechanism [\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (3) = 63; P &lt; .001), such that more head-to-ball concussions occurred in practice sessions (n = 92 [51.1%] vs n = 36 [17.1%]) and more head-to-head (n = 65 [30.8%] vs n = 20 [11.1]) and head-to-body (n = 76 [36%] vs n = 33 [18.3%]) concussions occurred in competition. The primary position was significantly associated with injury mechanism [\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (3) = 24; P &lt; .004], with goalkeepers having no SRCs from the head-to-head mechanism (n = 0 [0%]) and forward players having the least head-to-body mechanism (n = 15 [19.2%]). LOC was also associated with injury mechanism ( P = .034), with LOC being most prevalent in head-to-ground\/equipment. Finally, AMS was most prevalent in head-to-ball (n = 54 [34.2%]) and head-to-body (n = 48 [30.4%]) mechanisms [\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (3) = 9; P = .029]. In our multivariable models, the mechanism was not a predictor of TSS or RTP; however, it was associated with URTP ( P = .044), with head-to-equipment\/ground injuries resulting in the shortest mean number of days (14 \u00b1 9.1 days) to URTP and the head-to-ball mechanism the longest (18.6 \u00b1 21.6 days).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The mechanism of injury differed by event type and primary position, and LOC and AMS were different across mechanisms. Even though the mechanism of injury was not a significant predictor of acute symptom burden or time until RTP initiation, those with head-to-equipment\/ground injuries spent the shortest time until URTP, and those with head-to-ball injuries had the longest time until URTP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241240789","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T08:08:52Z","timestamp":1713946132000},"page":"1585-1595","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0424-3507","authenticated-orcid":false,"given":"Jacob","family":"Jo","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Vanderbilt University School of Medicine, Nashville, Tennessee, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian J.","family":"Boltz","sequence":"additional","affiliation":[{"name":"Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"McAllister","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"McCrea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Broglio","sequence":"additional","affiliation":[{"name":"Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Investigation performed at the Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA; Department of Neurological Surgery, Vanderbilt 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