Brief Report

The missing piece of the concussion discussion: primary prevention of mild traumatic brain injury in student athletes

Shawna Morrissey, Russell Dumire, Thomas Causer, Andrea Colton, Emma Oberlander, David Frye, Kosie Shepherd-Porada, Linda Frye


The majority of concussion research has focused on timely diagnosis and treatment, yet little has been reported on primary prevention. The goal of this study is to examine the use of core training as a preventative tool. We performed a non-randomized prospective study involving high school athletes. They participated in a 10-week training session with exercises focused on increasing core strength [mobility, agility, stability, strength and flexibility (MASSf)]. Logs were kept of all concussions diagnosed using ImPACT concussion testing. Statistical analysis was done using Chi-square to calculate expected/observed frequency and Chi-squared test statistic, χ2. Test significance was accepted at a P<0.01. One hundred and nineteen athletes participated in the 2014 pre-season MASSf training sessions. Utilizing 2010–2013 concussion data the calculated expected number of concussions for 2014 was 10.87. With the addition of the MASSf program the incidence of concussions was reduced to 2. Using a Chi-squared contingency test, our calculated test statistic, χ2=9.84, corresponds to a P value of 0.0017. The MASSf program was repeated in the 2015 season with 2 concussions in 121 participants. Our study showed a statistically significant decrease in concussion rates after participating in MASSf training. This program shows a promise as a primary prevention method to reduce sports related concussions.

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