{
  "abstract": "Objective To examine prevention strategies and potential modifiable risk factors (MRFs) for sport-related concussion (SRC) and head impact/head acceleration event (HAE) outcomes in female, woman and/or girl athletes.Design Systematic review with meta-analyses and Grading of Recommendations, Assessment, Development and Evaluation.Data sources Medline, CINAHL, PsycINfo, SportDiscus, ERIC, CENTRAL and CDSR.Eligibility Primary data studies with comparison group(s) assessing the association of prevention interventions and/or MRFs for SRC or HAE with ≥1 female/woman/girl in each study group.Results Of the 108 included studies, 67 evaluated a SRC prevention strategy (equipment n=25, policy/rule n=21, training n=10, management n=11) and 41 evaluated potential MRFs (34 distinct MRFs across nine categories). In total, 40/108 (37%) studies (prevention 19/67; MRF 21/41) included female/woman/girl-specific estimates. Three meta-analyses were conducted: two SRC prevention strategies (headgear, eyewear) and one MRF (artificial turf vs grass) based on availability of female/woman/girl-only estimates and similar outcomes and exposure. Headgear was associated with 30% lower SRC rates in adolescent female/girl lacrosse and soccer (IRR=0.70, 95% CI 0.50 to 0.99; very-low certainty). Eyewear use was not protective for SRC (IRR=1.08, 95% CI 0.69 to 1.68; very-low certainty). SRC rates did not differ by artificial turf versus grass (IRR=0.95, 95% CI 0.62 to 1.45; very-low certainty).Conclusion We found limited evidence for prevention strategies and MRFs in female/woman/girl athletes except for very-low certainty evidence supporting headgear use in adolescent lacrosse and soccer. Future studies should consider the design, implementation and evaluation of SRC prevention strategies that target MRFs to guide safe practice recommendations specifically for female/woman/girl athletes.",
  "authors": [
    {
      "affiliations": [
        "Edinburgh Sports Medicine Research Centre, Institute for Sport, PE and Health Sciences, University of Edinburgh, Edinburgh, UK",
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada",
        "UK Collaborating Centre on Injury and Illness Prevention in Sport, Universities of Edinburgh and Bath, Edinburgh and Bath, UK"
      ],
      "name": "Isla J Shill"
    },
    {
      "affiliations": [
        "Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Heather A Shepherd"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Paul H Eliason"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Ash T Kolstad"
    },
    {
      "affiliations": [
        "Carnegie School of Sport, Leeds Beckett University, Leeds, UK",
        "Rugby Football Union, Twickenham, UK"
      ],
      "name": "Omar Heyward"
    },
    {
      "affiliations": [
        "NeuroRecovery Lab, GIGA-Consciousness, University of Liège, Liège, Belgium"
      ],
      "name": "Géraldine Martens"
    },
    {
      "affiliations": [
        "FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland",
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Kerry Peek"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Clara A Soligon"
    },
    {
      "affiliations": [
        "Discipline of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia"
      ],
      "name": "Matthew G King"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada",
        "UK Collaborating Centre on Injury and Illness Prevention in Sport, Universities of Edinburgh of Bath, Edinburgh and Bath, UK",
        "Centre for Health, and Injury & Illness Prevention in Sport, University of Bath, Bath, UK"
      ],
      "name": "Stephen W West"
    },
    {
      "affiliations": [
        "The Football Association, Burton-upon-Trent, UK",
        "University Hospitals Dorset NHS Foundation Trust, Poole, UK",
        "School of Psychology, Sport and Health Sciences, University of Portsmouth, Portsmouth, UK"
      ],
      "name": "Osman Hassan Ahmed"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Cheri A Blauwet"
    },
    {
      "affiliations": [
        "University of Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA"
      ],
      "name": "Steven Broglio"
    },
    {
      "affiliations": [
        "Dept. of Psychiatry, University of Calgary, Calgary, Alberta, Canada",
        "Centre for Sport Leadership, Maties Sport, Stellenbosch University, Stellenbosch, South Africa"
      ],
      "name": "Araba Chintoh"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Jean-Michel Galarneau"
    },
    {
      "affiliations": [
        "Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "K Alix Hayden"
    },
    {
      "affiliations": [
        "Carnegie School of Sport, Leeds Beckett University, Leeds, UK",
        "Division of Physiological Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa"
      ],
      "name": "Sharief Hendricks"
    },
    {
      "affiliations": [
        "Australian Football League, Melbourne, Victoria, Australia",
        "La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia"
      ],
      "name": "Michael Makdissi"
    },
    {
      "affiliations": [
        "Edinburgh Sports Medicine Research Centre, Institute for Sport, PE and Health Sciences, University of Edinburgh, Edinburgh, UK",
        "UK Collaborating Centre on Injury and Illness Prevention in Sport, Universities of Edinburgh and Bath, Edinburgh and Bath, UK"
      ],
      "name": "Debbie Palmer"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Stacy Sick"
    },
    {
      "affiliations": [
        "Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada",
        "Arthritis Research Canada, Vancouver, British Columbia, Canada"
      ],
      "name": "Jackie L Whittaker"
    },
    {
      "affiliations": [
        "La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia"
      ],
      "name": "Kay M Crossley"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Kathryn J Schneider"
    },
    {
      "affiliations": [
        "Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Carolyn A Emery"
    }
  ],
  "title": "Prevention strategies and modifiable risk factors for concussion: a systematic review and meta-analysis for the Female, woman and girl/or Athlete Injury pRevention (FAIR) consensus",
  "uid": "f6b07a0f-1320-5a9a-93bc-55ff36ff6b3e"
}