{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T15:58:56Z","timestamp":1777737536272,"version":"3.51.4"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["26\/202.810\/2019(247397)"],"award-info":[{"award-number":["26\/202.810\/2019(247397)"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>This research study verified the technical\u2013tactical actions during the mixed martial arts (MMA) fights to generate serious enough injury to stop the MMA round, determining technical-tactical potential risk factors for injury in official MMA combats, according to Concussion or Resignation per Submission. A total of 990 rounds with concussions and 627 resignations per submission were considered with severe injury (i.e., a fight ended by a doctor or referee). All injuries were diagnosed and managed by attending ringside physicians during the MMA fights and rounds and had a continuous technical\u2013tactical behavior analysis, <jats:italic>p<\/jats:italic> \u2264 0.05. The leading cause of concussion was due to head trauma (~90%), with higher dependence on head strikes scored actions. Comparisons between Concussion and Resignation per Submission combats demonstrated differences between distance head strikes actions [13(6,25) vs. 9(4,18) frequencies], clinch head strikes actions [1(0;4) <jats:italic>vs<\/jats:italic>. 1(0;3) frequencies], ground head strikes actions [1(0;8) vs. 2(0;10) frequencies] and takedowns actions [0(0;1) <jats:italic>vs<\/jats:italic>. 1(0;2) frequencies]. This information may provide significant evidence regarding the doctor stoppage in concussion combats and when it could be called by officials supervising MMA.<\/jats:p>","DOI":"10.3389\/fneur.2022.941829","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T05:48:53Z","timestamp":1660801733000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Concussion vs. resignation by submission: Technical\u2013tactical behavior analysis considering injury in mixed martial arts"],"prefix":"10.3389","volume":"13","author":[{"given":"Bianca","family":"Miarka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dany A. Sobarzo","family":"Soto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esteban A.","family":"Aedo-Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00f3vis A.","family":"Maur\u00edcio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa T.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola L.","family":"Bragazzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciro Jos\u00e9","family":"Brito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1080\/24748668.2015.11868798","article-title":"Measuring the workload of mixed martial arts using accelerometry, time motion analysis and lactate","volume":"15","author":"Kirk","year":"2015","journal-title":"Int J Perform Anal Sport."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1975","DOI":"10.1519\/JSC.0000000000001287","article-title":"Comparisons technical-tactical and time-motion analysis of mixed martial arts by outcomes","volume":"30","author":"Miarka","year":"2016","journal-title":"J Strength Cond Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.7752\/jpes.2018.03250","article-title":"Effect of rule changes on technical-tactical actions correlated with injury incidence in professional mixed martial arts","volume":"18","author":"Fernandes","year":"2018","journal-title":"J Physic Educ Sport."},{"key":"B4","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1136\/bjsports-2016-097313","article-title":"A systematic review of prospective epidemiological research into injury and illness in Olympic combat sport","volume":"52","author":"Bromley","year":"2018","journal-title":"Br J Sports Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"213","DOI":"10.5604\/20831862.1150303","article-title":"Epidemiology of training injuries in amateur taekwondo athletes: a retrospective cohort study","volume":"32","author":"Lystad","year":"2015","journal-title":"Biol Sport."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1007\/s40279-016-0493-1","article-title":"Towards a determination of the physiological characteristics distinguishing successful mixed martial arts athletes: a systematic review of combat sport literature","volume":"46","author":"James","year":"2016","journal-title":"Sports Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"254","DOI":"10.3390\/ijerph16020254","article-title":"Dangers of mixed martial arts in the development of chronic traumatic encephalopathy","volume":"16","author":"Lim","year":"2019","journal-title":"Int J Environ Res Public Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1123\/ijspp.2017-0131","article-title":"A 12-year cohort study of doc-stoppage in professional mixed martial arts","volume":"14","author":"Miarka","year":"2019","journal-title":"Int J Sports Physiol Perform."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1177\/0363546514526151","article-title":"Head trauma in mixed martial arts","volume":"42","author":"Hutchison","year":"2014","journal-title":"Am J Sports Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1177\/1941738119827966","article-title":"Head trauma exposure in mixed martial arts varies according to sex and weight class","volume":"11","author":"Follmer","year":"2019","journal-title":"Sports Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1080\/02699052.2018.1553068","article-title":"The King-Devick test in mixed martial arts: the immediate consequences of knock-outs, technical knock-outs, and chokes on brain functions","volume":"33","author":"Hubbard","year":"2019","journal-title":"Brain Inj."},{"key":"B12","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1097\/JSM.0000000000000047","article-title":"Interrater agreement of an observational tool to code knockouts and technical knockouts in mixed martial arts","volume":"24","author":"Lawrence","year":"2014","journal-title":"Clin J Sport Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00913847.2022.2061836","article-title":"Examining the occurrence and outcomes of concussion and mTBI in mixed martial arts athletes: a systematic review","volume":"12","author":"Merino","year":"2022","journal-title":"Phys Sportsmed."},{"key":"B14","unstructured":"Incidence of injury in professional mixed martial arts competitions13642\n            BledsoeGH\n            HsuEB\n            GrabowskiJG\n            BrillJD\n            LiG\n          24357986J Sports Sci Med.52006"},{"key":"B15","first-page":"14","article-title":"Epidemiology of injuries in full-contact combat sports","volume":"22","author":"Lystad","year":"2015","journal-title":"Australas Epidemiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1212\/WNL.0000000000011750","article-title":"CSF and blood neurofilament levels in athletes participating in physical contact sports: a systematic review","volume":"96","author":"Verduyn","year":"2021","journal-title":"Neurology."},{"key":"B17","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1080\/00913847.2021.1885966","article-title":"Head injury in mixed martial arts: a review of epidemiology, affected brain structures and risks of cognitive decline","volume":"49","author":"Schlegel","year":"2021","journal-title":"Phys Sportsmed."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1016\/j.joms.2021.05.009","article-title":"Maxillofacial trauma in the ultimate fighting championship","volume":"79","author":"Sifuentes-Cervantes","year":"2021","journal-title":"J Oral Maxillofac Surg."},{"key":"B19","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s00784-020-03742-2","article-title":"Effects of competitive sports on temporomandibular dysfunction: a literature review","volume":"25","author":"Freiwald","year":"2021","journal-title":"Clin Oral Investig."},{"key":"B20","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1136\/bjsm.2007.044891","article-title":"Injury trends in sanctioned mixed martial arts competition: a 5-year review from 2002 to 2007","volume":"42","author":"Ngai","year":"2008","journal-title":"Br J Sports Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1136\/bjsports-2012-091011","article-title":"Competition injuries in taekwondo: a literature review and suggestions for prevention and surveillance","volume":"46","author":"Pieter","year":"2012","journal-title":"Br J Sports Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"117","DOI":"10.5812\/asjsm.34865","article-title":"An addendum to injury rates in Iranian taekwondo athletes; a prospective study","volume":"1","author":"Pieter","year":"2010","journal-title":"Asian J Sports Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2325967119865866","DOI":"10.1177\/2325967119865866","article-title":"Time-Loss injuries in karate: a prospective cohort study of 4 consecutive world karate championships","volume":"7","author":"Augustovicova","year":"2019","journal-title":"Orthop J Sports Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.scispo.2009.07.001","article-title":"Competition injury rates in young karate athletes","volume":"25","author":"Pieter","year":"2010","journal-title":"Sci Sports."},{"key":"B25","doi-asserted-by":"publisher","first-page":"185","DOI":"10.5114\/biolsport.2017.65338","article-title":"Kickboxing review: anthropometric, psychophysiological and activity profiles and injury epidemiology","volume":"34","author":"Slimani","year":"2017","journal-title":"Biol Sport."},{"key":"B26","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1136\/bjsm.37.5.448","article-title":"A 16-year study of injuries to professional kickboxers in the state of Victoria, Australia","volume":"37","author":"Zazryn","year":"2003","journal-title":"Br J Sports Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/00913847.2018.1552481","article-title":"Concussion reporting and perceived knowledge of professional fighters","volume":"47","author":"Bennett","year":"2019","journal-title":"Phys Sportsmed."},{"key":"B28","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1177\/1941738116664860","article-title":"Injuries sustained by the mixed martial arts athlete","volume":"9","author":"Jensen","year":"2017","journal-title":"Sports health."},{"key":"B29","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1080\/00913847.2020.1856631","article-title":"Concussion occurrence and recognition in professional boxing and MMA matches: toward a concussion protocol in combat sports","volume":"49","author":"Bernick","year":"2020","journal-title":"Phys Sportsmed"},{"key":"B30","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1136\/bjsports-2015-094978","article-title":"The incidence of concussion in youth sports: a systematic review and meta-analysis","volume":"50","author":"Pfister","year":"2015","journal-title":"Br J Sports Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1227\/01.NEU.0000175725.75780.DD","article-title":"Association between recurrent concussion and late-life cognitive impairment in retired professional football players","volume":"57","author":"Guskiewicz","year":"2005","journal-title":"Neurosurgery."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1093\/cercor\/bhs102","article-title":"Sports concussions and aging: a neuroimaging investigation","volume":"23","author":"Tremblay","year":"2013","journal-title":"Cereb Cortex."},{"key":"B33","doi-asserted-by":"publisher","first-page":"53","DOI":"10.3390\/sports7020053","article-title":"Epidemiology of sports related concussion in Brazilian Jiu-Jitsu: a cross-sectional study","volume":"7","author":"Spano","year":"2019","journal-title":"Sports."},{"key":"B34","volume-title":"Self-Reported Concussion among NCAA Student Athletes Executive Summary","author":"Bell","year":"2014"},{"key":"B35","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1097\/JSM.0000000000000235","article-title":"Combative sports injuries: an edmonton retrospective","volume":"26","author":"Karpman","year":"2015","journal-title":"Clin J Sport Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1136\/bjsm.2005.021295","article-title":"No holds barred sport fighting: a 10-year review of mixed martial arts competition","volume":"40","author":"Buse","year":"2006","journal-title":"Br J Sports Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1080\/24748668.2015.11868861","article-title":"Comparisons of time-motion analysis of mixed martial arts rounds by weight divisions","volume":"15","author":"Miarka","year":"2015","journal-title":"Int J Perform Anal Sport."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1089\/neu.2014.3833","article-title":"A longitudinal assessment of structural and chemical alterations in mixed martial arts fighters","volume":"32","author":"Mayer","year":"2015","journal-title":"J Neurotrauma."},{"key":"B39","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3174\/ajnr.A3676","article-title":"Diffusion measures indicate fight exposure\u2013related injury to cerebral white matter in boxers and mixed martial arts fighters","volume":"35","author":"Shin","year":"2014","journal-title":"Am J Neuroradiol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1080\/00913847.2020.1866958","article-title":"Analysis of the fight-ending chokes in the history of the Ultimate Fighting Championship\u2122 mixed martial arts promotion","volume":"50","author":"Stellpflug","year":"2020","journal-title":"Phys Sportsmed."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"Von Elm","year":"2007","journal-title":"PLoS Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.1136\/bjsports-2013-092886","article-title":"Injuries in judo: a systematic literature review including suggestions for prevention","volume":"47","author":"Pocecco","year":"2013","journal-title":"Br J Sports Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.jsams.2016.08.001","article-title":"Identifying the performance characteristics of a winning outcome in elite mixed martial arts competition","volume":"20","author":"James","year":"2017","journal-title":"J Sci Med Sport."},{"key":"B44","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1080\/24748668.2017.1360103","article-title":"Performance probabilities and outcome effects in technical\u2013tactical factors with bout phase changes of mixed martial arts","volume":"17","author":"Miarka","year":"2017","journal-title":"Int J Perform Anal Sport"},{"key":"B45","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1123\/ijspp.2012-0353","article-title":"Time-motion analysis and physiological responses to karate official combat sessions: is there a difference between winners and defeated karatekas?","volume":"9","author":"Chaabene","year":"2014","journal-title":"Int J Sports Physiol Perform."},{"key":"B46","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1136\/bjsports-2015-094913","article-title":"How reliable are functional movement screening scores? A systematic review of rater reliability","volume":"50","author":"Moran","year":"2016","journal-title":"Br J Sports Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1080\/00913847.2018.1430451","article-title":"Systematic review of injuries in mixed martial arts","volume":"46","author":"Thomas","year":"2018","journal-title":"Phys Sportsmed."},{"key":"B48","doi-asserted-by":"publisher","first-page":"2325967113518492","DOI":"10.1177\/2325967113518492","article-title":"The epidemiology of injuries in arts a systematic review and meta-analysis","volume":"2","author":"Lystad","year":"2014","journal-title":"Orthop J Sports Med."},{"key":"B49","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1515\/hukin-2017-0062","article-title":"Home advantage in judo: analysis by the combat phase, penalties and the type of attack","volume":"57","author":"Brito","year":"2017","journal-title":"J Hum Kinet."},{"key":"B50","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1123\/ijspp.2015-0659","article-title":"the activity profile of elite low-kick kickboxing competition","volume":"12","author":"Slimani","year":"2017","journal-title":"Int J Sports Physiol Perform"},{"key":"B51","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1519\/JSC.0b013e3182541edd","article-title":"Time-motion analysis of youth Olympic Taekwondo combats","volume":"27","author":"Tornello","year":"2013","journal-title":"J Strength Cond Res."},{"key":"B52","doi-asserted-by":"crossref","DOI":"10.1519\/JSC.0000000000003018","article-title":"Suggestions for professional mixed martial arts training with pacing strategy and technical-tactical actions by rounds","volume-title":"J Strength Cond Res","author":"Antonietto","year":"2019"},{"key":"B53","doi-asserted-by":"publisher","first-page":"271","DOI":"10.2478\/hukin-2018-0081","article-title":"Ending MMA combat, specific grappling techniques according to the type of the outcome","volume":"67","author":"Dal Bello","year":"2019","journal-title":"J Hum Kinet."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1519\/JSC.0000000000002078","article-title":"Mixed martial arts induces significant fatigue and muscle injury Up to 24 hours post-combat","volume":"33","author":"Ghoul","year":"2019","journal-title":"J Strength Cond Res."},{"key":"B55","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1037\/1040-3590.6.4.284","article-title":"Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology","volume":"6","author":"Cicchetti","year":"1994","journal-title":"Psychol Assess."},{"key":"B56","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1089\/neu.2019.6483","article-title":"Dynamic blood-brain barrier regulation in mild traumatic brain injury","volume":"37","author":"O'Keeffe","year":"2019","journal-title":"J Neurotrauma"},{"key":"B57","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1111\/cpf.12447","article-title":"Assessing prefrontal cortex oxygenation after sport concussion with near-infrared spectroscopy","volume":"38","author":"Bishop","year":"2018","journal-title":"Clin Physiol Funct Imaging."},{"key":"B58","doi-asserted-by":"publisher","first-page":"132","DOI":"10.4085\/1062-6050-297-18","article-title":"History of sport-related concussion and long-term clinical cognitive health outcomes in retired athletes: a systematic review","volume":"55","author":"Cuningham","year":"2020","journal-title":"J Athletic Training."},{"key":"B59","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1123\/jsr.2018-0168","article-title":"The effect of concussive injury on individual game performance in professional collision-sport athletes","volume":"28","author":"Ochs","year":"2019","journal-title":"J Sport Rehabil."},{"key":"B60","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1123\/ijspp.2018-0566","article-title":"10 years on time-motion and motor actions of paired mixed martial arts athletes","volume":"14","author":"Dos Santos","year":"2019","journal-title":"Int J Sports Physiol Perform"},{"key":"B61","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1080\/17461391.2016.1161073","article-title":"Impact attenuation of protective boxing and taekwondo headgear","volume":"16","author":"O'Sullivan","year":"2016","journal-title":"Euro J Sports Sci."},{"key":"B62","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2016.1.FOCUS15615","article-title":"Rugby headgear and concussion prevention: misconceptions could increase aggressive play","volume":"40","author":"Menger","year":"2016","journal-title":"Neurosurg Focus."},{"key":"B63","doi-asserted-by":"publisher","first-page":"2325967115612416","DOI":"10.1177\/2325967115612416","article-title":"Injuries to professional and amateur kickboxing contestants: a 15-year retrospective cohort study","volume":"3","author":"Lystad","year":"2015","journal-title":"Orthop J Sports Med"},{"key":"B64","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1519\/JSC.0000000000001804","article-title":"Differences by ending-rounds and other rounds in time-motion analysis of mixed martial arts: implications for assessment and training","volume":"32","author":"Miarka","year":"2017","journal-title":"J Strength Cond Res"},{"key":"B65","unstructured":"2022"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.941829\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T15:46:49Z","timestamp":1661960809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.941829\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":65,"alternative-id":["10.3389\/fneur.2022.941829"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.941829","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,18]]},"article-number":"941829"}}