@Article{Trabelsi2026,
journal="Biology of Sport",
issn="0860-021X",
year="2026",
title="What evidence supports primary prevention strategies for sport-related concussion? An umbrella review",
abstract=" This umbrella review aimed to systematically evaluate and synthesize evidence from published  systematic reviews on the effectiveness of primary prevention strategies for sport-related concussion (SRC) in  athletes, and to identify areas of uncertainty relevant to policy and practice. A comprehensive search of the  Cochrane Database of Systematic Reviews, Epistemonikos, ERIC, PsycINFO, PubMed, Scopus, SPORTDiscus, and  Web of Science was conducted from 2001 to April 2025, with an updated search in November 2025. Peer reviewed systematic reviews, with or without meta-analyses, assessing primary prevention strategies to reduce  SRC incidence in competitive athletes of any age or sex were eligible. Interventions included rule or policy  changes, protective equipment, educational programs and training-based strategies. Twenty-five systematic  reviews were included, eight of which contained meta-analyses; all were rated as critically low quality using  the AMSTAR-2 tool. Rule and policy changes, particularly the disallowance of body checking in youth ice hockey,  demonstrated the most consistent evidence for reducing SRC incidence. Meta-analyses evaluating mouthguards  and headgear showed substantial overlap of primary studies and inconsistent effects. Educational interventions  and training-based programs, including structured warm-up programs such as FIFA 11+ Kids, produced  inconclusive findings. Evidence specific to female athletes was limited and insufficient to support any particular  prevention strategy. Overall, rule and policy changes that reduce exposure to high-risk contact currently have  the strongest supporting evidence for SRC prevention, whereas evidence for equipment, education and training  remains mixed. Given the critically low methodological quality of existing reviews, higher-quality evidence  syntheses and robust primary studies are urgently needed. ",
author="Trabelsi, Khaled
and Boukhris, Omar
and Chebbi, Souhail
and Husain, Waqar
and Ammar, Achraf
and Holtzhausen, Louis
and Chtourou, Hamdi
and Chamari, Karim
and Jahrami, Haitham",
pages="1589--1614",
doi="10.5114/biolsport.2026.161108",
url="http://dx.doi.org/10.5114/biolsport.2026.161108"
}