Health And Performance Promotion in Youth Sport (HAPPY): Concussion Incidence Rates, Initial Management, Symptoms, and Missed Activities in Danish Youth Handball Players

OBJECTIVES: To estimate concussion incidence rates, and describe initial management, symptoms and missed activities after concussion in community handball players aged 11-17 years over one season. DESIGN: 30-week prospective cohort study METHODS: Each week, youth handball players self-reported handball exposure (training and match) and possible concussions using the Oslo Sports and Trauma Research Health questionnaire and a concussion question defined according to the 5 th Concussion in Sport Group Consensus Statement. Possible concussions were confirmed via telephone interviews using the Acute Concussion Evaluation form within one week of self-report. Incidence rates ratios (IRR) were calculated using Poisson regressions considering observations clustered within clubs. We compared results between sex and age groups. RESULTS: Among 945 players (55% female), the incidence rate was 0.8/1000 exposure hours (95%CI 0.6-1.0) with no sex difference (female versus male IRR 1.6 (95%CI 0.8-3.0). The IRRs were higher in the U15 and U17 age groups compared to U13 (U15 versus U13 (IRR: 1.6 (95%CI 1.0-2.7) and U17 versus U13 (IRR 2.3 (95%CI 1.2-4.1)). Players reported a median of 7(interquartile range 3-11) symptoms, mostly headaches (96%,95%CI84-98%). Forty-nine per cent (95%CI 36-63%) continued to play after the incident, with 96% (95%CI75-100%) of these players deciding independently, 19% (95%CI10-32%) consulting a health professional. One in 4 players missed at least one school day (25%, 95%CI15-38%) or sports activity (23%, 95%CI13-36%) respectively. CONCLUSION: Concussions were common in youth handball, and occurred more often in older age groups, with no differences by sex. Half of handball players continued playing immediately post-injury, mainly deciding independently, and one in four missed school or sports.