{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:40:13Z","timestamp":1759207213041,"version":"3.44.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sports-related concussions (SRC) are a pressing global health concern. However, countries in the Global South often lack standardized diagnostic criteria, and limited medical resources lead to inconsistent SRC detection. Our study presents a culturally adapted concussion detection protocol implemented by the region\u2019s governing soccer federation, CONMEBOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Concussion Fast Recognition Protocol (CFRP) was developed by adapting the Sport Concussion Assessment Tool, the Standardized Assessment of Concussion, and incorporating community-level input to ensure cultural relevance. The protocol was written in English, Spanish, and Portuguese. On-field medical teams completed the CFRP after each CONMEBOL match (<jats:italic>N<\/jats:italic>\u202f=\u202f156) from 2022 to 2024, regardless of whether an SRC occurred. Players included in the study (<jats:italic>N<\/jats:italic>\u202f=\u202f5,928) ranged in age from 15\u201344\u202fyears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 27 concussions were identified, all of which were immediately removed from play. Most concussions (37.04%) occurred during the 21\u201345-min period, and 59.26% involved away-team athletes. The incidence rate per 1,000 player-hours was 2.61. Game temperatures ranged from 7 \u00b0C to 36 \u00b0C, and the maximum altitude reached 4,150 meters. The distance covered by players ranged from 550 to 6,100 meters. Incidence rates per 1,000 player-hours were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This first large-scale, prospective SRC study in South American soccer demonstrates effective implementation of a regional protocol and identifies context-related trends in SRC risk. The findings underscore the importance of a culturally appropriate protocol and contribute novel data to global concussion literature.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1645543","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:11:00Z","timestamp":1759205460000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Concussions analysis in 2022\u20132024 CONMEBOL soccer tournaments"],"prefix":"10.3389","volume":"16","author":[{"given":"Osvaldo","family":"Pangrazio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Forriol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex S.","family":"Aguirre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Bastin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alcy R.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"102763","DOI":"10.1016\/j.bas.2024.102763","article-title":"Sport-related concussion in soccer\u2014a scoping review of available guidelines and a call for action to FIFA & soccer governing bodies","volume":"4","author":"Demetriades","year":"2024","journal-title":"Brain Spine"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.csm.2020.08.013","article-title":"Epidemiology of sport-related concussion","volume":"40","author":"Pierpoint","year":"2021","journal-title":"Clin Sports Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.wneu.2011.10.032","article-title":"Concussions in soccer: a current understanding","volume":"78","author":"Levy","year":"2012","journal-title":"World Neurosurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.spen.2019.03.003","article-title":"Definition, classification, and epidemiology of concussion","volume":"30","author":"Kazl","year":"2019","journal-title":"Semin Pediatr Neurol"},{"key":"ref5","volume-title":"Medical commission protocols","year":"2024"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1097\/JNN.0b013e31823858a6","article-title":"Concussion and the adolescent athlete","volume":"43","author":"Kimbler","year":"2011","journal-title":"J Neurosci Nurs"},{"key":"ref7","volume-title":"Translational research in traumatic brain injury","author":"Clark","year":"2016"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e64064","DOI":"10.7759\/cureus.64064","article-title":"Enhancing protocols for concussion management in professional soccer events","volume":"16","author":"Pangrazio","year":"2024","journal-title":"Cureus"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e20160910","DOI":"10.1542\/peds.2016-0910","article-title":"Removal from play after concussion and recovery time","volume":"138","author":"Elbin","year":"2016","journal-title":"Pediatrics"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"329","DOI":"10.4085\/1062-6050-51.5.02","article-title":"\u201cPlaying through it\u201d: delayed reporting and removal from athletic activity after concussion predicts prolonged recovery","volume":"51","author":"Asken","year":"2016","journal-title":"J Athl Train"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1136\/bjsports-2017-097506","article-title":"The Sport Concussion Assessment Tool 5th edition (SCAT5): background and rationale","author":"Echemendia","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref12","volume-title":"Protocolo de Recomendaciones Medicas Competencias","author":"Pangrazio","year":"2023"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e024607","DOI":"10.1136\/bmjopen-2018-024607","article-title":"Medical assessment of potential concussion in elite football: video analysis of the 2016 UEFA European championship","volume":"9","author":"Abraham","year":"2019","journal-title":"BMJ Open"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1111\/sms.13852","article-title":"Video analysis of concussion mechanisms and immediate management in French men\u2019s professional football (soccer) from 2015 to 2019","volume":"31","author":"Cassoudesalle","year":"2021","journal-title":"Scand J Med Sci Sports"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1177\/0363546519859542","article-title":"Concussion in American versus European professional soccer: a decade-long comparative analysis of incidence, return to play, performance, and longevity","volume":"47","author":"Ramkumar","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1111\/sms.13644","article-title":"Concussion incidence and recovery in Swedish elite soccer\u2014prolonged recovery in female players","volume":"30","author":"Vedung","year":"2020","journal-title":"Scand J Med Sci Sports"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1136\/bjsports-2012-091941","article-title":"American Medical Society for Sports Medicine position statement: concussion in sport","volume":"47","author":"Harmon","year":"2013","journal-title":"Br J Sports Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1097\/JSM.0b013e31827ee6f8","article-title":"Head and neck injuries in professional soccer","volume":"23","author":"Nilsson","year":"2013","journal-title":"Clin J Sport Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1177\/03635465241240789","article-title":"Mechanisms of injury leading to concussions in collegiate soccer players: a CARE consortium study","volume":"52","author":"Jo","year":"2024","journal-title":"Am J Sports Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1177\/0363546513485358","article-title":"Lower injury rates for newcomers to professional soccer: a prospective cohort study over 9 consecutive seasons","volume":"41","author":"Kristenson","year":"2013","journal-title":"Am J Sports Med"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1645543\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:11:01Z","timestamp":1759205461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1645543\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":20,"alternative-id":["10.3389\/fneur.2025.1645543"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1645543","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]},"article-number":"1645543"}}