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Review

Headguard use in combat sports: position statement of the Association of Ringside Physicians

, , , &
Pages 229-238 | Received 22 Jun 2023, Accepted 26 Jul 2023, Published online: 28 Aug 2023

References

  • Loosemore MP, Butler CF, Khadri A, et al. Use of headguards in AIBA boxing tournaments: a cross-sectional observational study. Clin J Sport Med. 2017;27(1):86–88. doi: 10.1097/JSM.0000000000000322
  • Tjønndal A, Haudenhuyse R, de Geus B, et al. Concussions, cuts, and cracked bones: a systematic literature review on protective headgear and head injury prevention in Olympic boxing. Eur J Sport Sci. 2022;22(3):447–459. doi: 10.1080/17461391.2021.1872711
  • Jansen AE, McGrath M, Samorezov S, et al. Characterizing head impact exposure in men and women during boxing and mixed martial arts. Orthop J Sports Med. 2021;9(12):23259671211059815. doi: 10.1177/23259671211059815
  • Pieter W. Martial arts injuries. Med Sport Sci. 2005;48:59–73.
  • Lystad RP, Gregory K, Wilson J. The epidemiology of injuries in mixed martial arts: a systematic review and meta-analysis. Orthop J Sports Med. 2014;2(1):2325967113518492. doi: 10.1177/2325967113518492
  • Fares MY, Salhab HA, Fares J, et al. Craniofacial and traumatic brain injuries in mixed martial arts. Phys Sportsmed. 2021;49(4):420–428. doi: 10.1080/00913847.2020.1847623
  • Wolfe EM, Pierrot RG, Slavin BR, et al. Rolling with the punches: a national electronic injury surveillance system database study of craniofacial injuries in boxing. J Craniofac Surg. 2021;32(4):1576–1580. doi: 10.1097/SCS.0000000000007640
  • Karpman S, Reid P, Phillips L. Phillips L et al.Combative sports injuries. Clin J Sport Med. 2016;26(4):332–334. doi: 10.1097/JSM.0000000000000235
  • McClain R, Wassermen J, Mayfield C, et al. Injury profile of mixed martial arts competitors. Clin J Sport Med. 2014;24(6):497–501. doi: 10.1097/JSM.0000000000000078
  • Hojjat H, Svider PF, Lin H-S, et al. Adding injury to insult: a national analysis of combat sport–related facial injury. Ann Otol Rhinol Laryngol. 2016;125(8):652–659. doi: 10.1177/0003489416644617
  • Arriaza R, Leyes M. Injury profile in competitive karate: prospective analysis of three consecutive world karate championships. Knee Surg Sports Traumatol Arthrosc. 2005;13(7):603–607. doi: 10.1007/s00167-004-0593-6
  • Schlüter-Brust K, Leistenschneider P, Dargel J, et al. Acute injuries in taekwondo. Int J Sports Med. 2011;32(8):629–634. doi: 10.1055/s-0031-1275302
  • Siewe J, Rudat J, Zarghooni K, et al. Injuries in competitive boxing. A prospective study. Int J Sports Med. 2015;36(3):249–253. doi: 10.1055/s-0034-1387764
  • Zazryn TR, Finch CF, McCrory P. A 16-year study of injuries to professional boxers in the state of Victoria, Australia. Br J Sports Med. 2003;37(4):321–324. doi: 10.1136/bjsm.37.4.321
  • Alevras AJ, Fuller JT, Mitchell R, et al. Epidemiology of injuries in amateur boxing: a systematic review and meta-analysis. J Sci Med Sport. 2022;25(12):995–1001. doi: 10.1016/j.jsams.2022.09.165
  • Zazryn T, Cameron P, McCrory P. A prospective cohort study of injury in amateur and professional boxing. Br J Sports Med. 2006;40(8):670–674. doi: 10.1136/bjsm.2006.025924
  • Public Health Agency of Canada, Health Surveillance and epidemiology division of injuries associated with formal boxing. Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) Database,1990–2007 (cumulative to December 2008), ages 5 years and older (273 records). Available from https://www.canada.ca/en/public-health/services/injury-prevention/health-surveillence-epidemiology-division.html
  • Neidecker J, Martin J. Mortality resulting from head injury in professional boxing revisited: fatalities from 2000-2019. J Combat Sports Med. 2022;4S:38.
  • Baird LC, Newman CB, Volk H, et al. Mortality resulting from head injury in professional boxing. Neurosurgery. 2010;67(5):1444–1450. doi: 10.1227/NEU.0b013e3181e5e2cd
  • Alevras AJ, Fuller JT, Mitchell R, et al. Boxing-related fatalities in Australia: a retrospective analysis of news media reports. J Sci Med Sport. 2022;25(1):25–30. doi: 10.1016/j.jsams.2021.08.002
  • Thomas RE, Thomas BC. Systematic review of injuries in mixed martial arts. Phys Sportsmed. 2018;46(2):155–167. doi: 10.1080/00913847.2018.1430451
  • Loosemore M, Knowles CH, Whyte GP. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies. BMJ. 2007;335(7624):809. doi: 10.1136/bmj.39342.690220.55
  • Nowinski CJ, Bureau SC, Buckland ME, et al. Applying the Bradford Hill Criteria for causation to repetitive head impacts and chronic traumatic encephalopathy. Front Neurol. 2022 Jul 22;13:938163. doi: 10.3389/fneur.2022.938163
  • Schlegel P, Novotny M, Valis M, et al. Head injury in mixed martial arts: a review of epidemiology, affected brain structures and risks of cognitive decline. Phys Sportsmed. 2021;49(4):371–380. doi: 10.1080/00913847.2021.1885966
  • Buse GJ. No holds barred sport fighting: a 10-year review of mixed martial arts competition. Br J Sports Med. 2006;40(2):169–172. doi: 10.1136/bjsm.2005.021295
  • Hutchison MG, Lawrence DW, Cusimano MD, et al. Head trauma in mixed martial arts. Am J Sports Med. 2014;42(6):1352–1358. doi: 10.1177/0363546514526151
  • Lystad RP, Augustovičová D, Harris G, et al. Epidemiology of injuries in Olympic-style karate competitions: systematic review and meta-analysis. Br J Sports Med. 2020;54(16):976–983. doi: 10.1136/bjsports-2020-101990
  • Lystad RP, Pollard H, Graham PL. Epidemiology of injuries in competition taekwondo: a meta-analysis of observational studies. J Sci Med Sport. 2009;12(6):614–621. doi: 10.1016/j.jsams.2008.09.013
  • Zazryn TR, McCrory PR, Cameron PA. Neurologic injuries in boxing and other combat sports. Phys Med Rehabil Clin N Am. 2009;20(1):227–239. doi: 10.1016/j.pmr.2008.10.004
  • Pocecco E, Ruedl G, Stankovic N, et al. Injuries in judo: a systematic literature review including suggestions for prevention. Br J Sports Med. 2013;47(18):1139–1143. doi: 10.1136/bjsports-2013-092886
  • Powell JR, Boltz AJ, Robison HJ, et al. Epidemiology of injuries in national collegiate athletic association of men’s wrestling: 2014-2015 through 2018-2019. J Athl Train. 2021;56(7):727–733. doi: 10.4085/1062-6050-429-20
  • Myers RJ, Linakis SW, Mello MJ, et al. Competitive wrestling-related injuries in school aged athletes in U.S. emergency departments. West J Emerg Med. 2010;11(5):442–449.
  • Schuller DE, Dankle SK, Martin M, et al. Auricular injury, and the use of headgear in wrestlers. Arch Otolaryngol Head Neck Surg. 1989;115(6):714–717. doi: 10.1001/archotol.1989.01860300068019
  • AIBA. AIBA Open boxing (AOC) competition rules. Lausanne: AIBA; 2013.
  • McIntosh AS, Patton DA. Boxing headguard performance in punch machine tests. Br J Sports Med. 2015;49(17):1108–1112. doi: 10.1136/bjsports-2015-095094
  • McIntosh AS, Andersen TE, Bahr R, et al. Sports helmets now and in the future. Br J Sports Med. 2011 Dec;45(16):1258–1265. doi: 10.1136/bjsports-2011-090509
  • McIntosh AS, Patton DA. The impact performance of headguards for combat sports. Br J Sports Med. 2015;49(17):1113–1117. doi: 10.1136/bjsports-2015-095093
  • O’Sullivan DM, Fife GP. Impact attenuation of protective boxing and taekwondo headgear. Eur J Sport Sci. 2016;16(8):1219–1225. doi: 10.1080/17461391.2016.1161073
  • Finan JD, Nightingale RW, Myers BS. The influence of reduced friction on head injury metrics in helmeted head impacts. Traffic Inj Prev. 2008 Oct;9(5):483–488. doi: 10.1080/15389580802272427
  • Gilchrist A, Mills NJ. Protection of the side of the head. Accid Anal Prev. 1996;28(4):525–535. doi: 10.1016/0001-4575(96)00030-9
  • Hrysomallis C. Impact energy attenuation of protective football headgear against a yielding surface. J Sci Med Sport. 2004;7(2):156–164. doi: 10.1016/S1440-2440(04)80005-7
  • McIntosh AS, McCrory P. Impact energy attenuation performance of football headgear. Br J Sports Med. 2000;34(5):337–341. doi: 10.1136/bjsm.34.5.337
  • Pieter W, Fife GP, O’Sullivan DM. Diminished impact attenuation properties of taekwondo and boxing headgear [abstract], 5th IOC world conference on prevention of injury & illness in sport 2012. Br J Sports Med. 2014;48(7):652. doi: 10.1136/bjsports-2014-093494.246
  • Tierney RT, Higgins M, Caswell SV, et al. Sex differences in head acceleration during heading while wearing soccer headgear. J Athl Train. 2008;43(6):578–584. doi: 10.4085/1062-6050-43.6.578
  • Withnall C, Shewchenko N, Wonnacott M, et al. Effectiveness of headgear in football. Br J Sports Med. 2005;39(Suppl 1):i40–8. doi: 10.1136/bjsm.2005.019174
  • Bartsch AJ, Benzel EC, Miele VJ, et al. Boxing and mixed martial arts: preliminary traumatic neuromechanical injury risk analyses from laboratory impact dosage data. J Neurosurg. 2012;116(5):1070–1080. doi: 10.3171/2011.12.JNS111478
  • Stojsih S, Boitano M, Wilhelm M, et al. A prospective study of punch biomechanics and cognitive function for amateur boxers. Br J Sports Med. 2010;44(10):725–730. doi: 10.1136/bjsm.2008.052845
  • Pierce JD, Reinbold KA, Lyngard BC, et al. Direct measurement of punch force during six professional boxing matches. J Quant Anal Sports. 2006;2(2):1–19. doi: 10.2202/1559-0410.1004
  • Smith MS. Physiological profile of senior and junior England international amateur boxers. J Sports Sci Med. 2006;5(CSSI):74–89.
  • Zhang L, Yang KH, King AI. A proposed injury threshold for mild traumatic brain injury. J Biomech Eng. 2004;126(2):226–236. doi: 10.1115/1.1691446
  • Haug RH, Savage JD, Likavec MJ, et al. A review of 100 closed head injuries associated with facial fractures. J Oral Maxillofac Surg. 1992;50(3):218–222. doi: 10.1016/0278-2391(92)90315-Q
  • Ommaya AK, Goldsmith W, Thibault L. Biomechanics, and neuropathology of adult and paediatric head injury. Br J Neurosurg. 2002;16(3):220–242. doi: 10.1080/02688690220148824
  • Post A, Hoshizaki BT. Rotational acceleration, brain tissue strain, and the relationship to concussion. J Biomech Eng. 2015;137(3). doi: 10.1115/1.4028983
  • Walilko TJ, Viano DC, Bir CA. Biomechanics of the head for Olympic boxer punches to the face. Br J Sports Med. 2005;39(10):710–719. doi: 10.1136/bjsm.2004.014126
  • Delaney J, Puni V, Rouah F. Mechanisms of injury for concussions in university football, ice hockey, and soccer: a pilot study. Clin J Sport Med. 2006;16(2):162–165. doi: 10.1097/00042752-200603000-00013
  • Li H, Lu RJ, Wu P, et al. Numerical simulation, and analysis of midfacial impacts and traumatic brain injuries. Ann Transl Med. 2021;9(6):459. doi: 10.21037/atm-21-134
  • Atha J, Yeadon MR, Sandover J, et al. The damaging punch. Br Med J (Clin Res Ed). 1985;291(6511):1756–1757. doi: 10.1136/bmj.291.6511.1756
  • Joch W, Fritche P, Krause I. Biomechanical analysis of punching boxing: In: Morecki A, Fidelus K Kedzior K, Biomechanics VII-A. Baltimore (MD): University Park Press, p. 343–349:1981.
  • Roberts AH. Brain damage in boxers: a study of the prevalence of traumatic encephalopathy among ex-professional boxers. London: Pitman Medical and Scientific Publishing; 1969.
  • Smith PK, Hamill J. The effect of punching glove type and skill level of momentum transfer. J Hum Mov Stud. 1986;12(3):153–161.
  • Cournoyer J, Hoshizaki TB. Head dynamic response and brain tissue deformation for boxing punches with and without loss of consciousness. Clin Biomech (Bristol, Avon). 2019;67:96–101.
  • Fife GP, O’Sullivan DM, Pieter W, et al. Effects of Olympic-style taekwondo kicks on an instrumented head-form and resultant injury measures. Br J Sports Med. 2013;47(18):1161–1165. doi: 10.1136/bjsports-2012-090979
  • Davis P, Waldock R, Connorton A, et al. Comparison of amateur boxing before and after the 2013 rules change and the impact on boxers’ safety. Br J Sports Med. 2018;52(11):741–746. doi: 10.1136/bjsports-2017-097667
  • Davis P, Connorton AJ, Driver S, et al. The activity profile of elite male amateur boxing after the 2013 rule changes. J Strength Cond Res. 2018;32(12):3441–3446. doi: 10.1519/JSC.0000000000001864
  • Lystad RP, Alevras A, Rudy I, et al. Injury incidence, severity and profile in Olympic combat sports: a comparative analysis of 7712 athlete exposures from three consecutive Olympic games. Br J Sports Med. 2021;55(19):1077–1083. doi: 10.1136/bjsports-2020-102958
  • Bianco M, Loosemore M, Daniele G, et al. Amateur boxing in the last 59 years. Impact of rules changes on the type of verdicts recorded and implications on boxers’ health. Br J Sports Med. 2013;47(7):452–457. doi: 10.1136/bjsports-2012-091771
  • Dickinson P, Rempel P. Prohibiting headgear for safety in amateur boxing? Opinion of the Canadian boxing community: an online poll. Sports Med - Open. 2016;2(1):1–11. doi: 10.1186/s40798-016-0043-2
  • Sethi N. In response to use of headguards in AIBA boxing tournaments—a cross-sectional observational study. Clin J Sport Med. 2018;28(1):e1. doi: 10.1097/JSM.0000000000000401
  • Casson IR, Viano DC, Powell JW, et al. Twelve years of national football league concussion data. Sports Health. 2010;2(6):471–483. doi: 10.1177/1941738110383963
  • McCrea M, Guskiewicz KM, Marshall SW, et al. Acute effect and recovery time following concussion in collegiate football players: the NCAA concussion study. JAMA. 2003;290(19):2556–2563. doi: 10.1001/jama.290.19.2556
  • Center for Disease Control and Prevention. Answering questions about chronic traumatic encephalopathy (CTE).https://www.cdc.gov/traumaticbraininjury/pdf/CDC-CTE-FactSheet-508.pdf. Accessed 15May2023.
  • National Institute of Neurological Disorders and Stroke. Focus on traumatic brain injury research. https://www.ninds.nih.gov/current-research/focus-disorders/focus-traumatic-brain-injury-research. Accessed 15May2023.
  • Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. Br J Sports Med. 2017;51(12):978–984. doi: 10.1136/bjsports-2016-097452
  • Knight J, Nguyen JVK, Mitra B, et al. Soft-shell headgear, concussion, and injury prevention in youth team collision sports: a systematic review. BMJ Open. 2021;11(6):e044320. doi: 10.1136/bmjopen-2020-044320
  • Schneider DK, Grandhi RK, Bansal P, et al. Current state of concussion prevention strategies: a systematic review and meta-analysis of prospective, controlled studies. Br J Sports Med. 2017;51(20):1473–1482. doi: 10.1136/bjsports-2015-095645
  • Willick SE, Wagner G, Ericson D, et al. Helmet use and risk-taking behavior among Skiers and Snowboarders. Clin J Sport Med. 2019;29(4):329–335. doi: 10.1097/JSM.0000000000000527
  • Phillips RO, Fyhri A, Sagberg F. Risk compensation and bicycle helmets. Risk Anal. 2011;31(8):1187–1195. doi: 10.1111/j.1539-6924.2011.01589.x

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