{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:29:28Z","timestamp":1792196968062,"version":"4.4.0"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Ongoing monitoring of concussion rates and distributions is important in assessing temporal patterns. Examinations of high school sport-related concussions need to be updated. This study describes the epidemiology of concussions in 20 high school sports during the 2013\u20132014 to 2017\u20132018 school years.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this descriptive epidemiology study, a convenience sample of high school athletic trainers provided injury and athlete exposure (AE) data to the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online). Concussion rates per 10\u2009000 AEs with 95% confidence intervals (CIs) and distributions were calculated. Injury rate ratios and injury proportion ratios examined sex differences in sex-comparable sports (soccer, basketball, baseball and softball, cross country, track, and swimming). We also assessed temporal trends across the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Overall, 9542 concussions were reported for an overall rate of 4.17 per 10\u2009000 AEs (95% CI: 4.09 to 4.26). Football had the highest concussion rate (10.40 per 10\u2009000 AEs). Across the study period, football competition-related concussion rates increased (33.19 to 39.07 per 10\u2009000 AEs); practice-related concussion rates decreased (5.47 to 4.44 per 10\u2009000 AEs). In all sports, recurrent concussion rates decreased (0.47 to 0.28 per 10\u2009000 AEs). Among sex-comparable sports, concussion rates were higher in girls than in boys (3.35 vs 1.51 per 10\u2009000 AEs; injury rate ratio = 2.22; 95% CI: 2.07 to 2.39). Also, among sex-comparable sports, girls had larger proportions of concussions that were recurrent than boys did (9.3% vs 6.4%; injury proportion ratio = 1.44; 95% CI: 1.11 to 1.88).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Rates of football practice-related concussions and recurrent concussions across all sports decreased. Changes in concussion rates may be associated with changes in concussion incidence, diagnosis, and management. Future research should continue to monitor trends and examine the effect of prevention strategies.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2019-2180","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T12:25:34Z","timestamp":1571142334000},"source":"Crossref","is-referenced-by-count":171,"title":["Concussion Incidence and Trends in 20 High School Sports"],"prefix":"10.1542","volume":"144","author":[{"given":"Zachary Y.","family":"Kerr","sequence":"first","affiliation":[{"name":"Department of Exercise and Sport Science, and"},{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, and"},{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliza K.","family":"Nedimyer","sequence":"additional","affiliation":[{"name":"Human Movement Science Curriculum,"},{"name":"Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Arakkal","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Anschutz Medical Campus, University of Colorado Denver, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren A.","family":"Pierpoint","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute, Vail, Colorado; 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