1. The Effect of Predisposing Factors and Concussion Rate on DIII College Football Players: A Retrospective Study Jon Purvis, Robert Blume, Jenna Chinburg, and Michael Doersch Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI ABSTRACT With concussions representing one of the most serious sports injuries and a higher incidence among football players, athletic trainers need to be aware of potential factors that are not manipulative. The purpose of our study is to investigate the effect of predisposing factors and past concussion history on the rate of concussion in Wisconsin Intercollegiate Athletic Conference (WIAC) Division III college football players. Many factors are attributed to concussion susceptibility such as mechanism of injury (MOI; contact vs. noncontact), age, and position. By determining the factors that increase risk of concussion, we can identify individuals more prone to injury. An electronic Qualtrics survey was sent to 8 out of 9 head athletic trainers in the WIAC via e-mail to gather information on predisposing factors and individual concussion reports from the years of 2009-2013. Through data collection, we employed a one-way ANOVA and post-hoc tests to examine the impact of position, age, MOI, and environmental factors on the rate of concussion among those athletes who were concussed. We hypothesized that the predisposing factors of position and environmental factors would show a direct correlation to the rate of concussion within the fixed timespan, although environmental factors showed no significance overall. The factors of days withheld from activity, number of symptoms from SCAT 2/3, and position showed significant findings respectively. Additional investigation on predisposing factors will potentially help to continuously reduce the concussion rate among football players and improve prevention strategies. Procedures  Requests to participate were sent via email to the head athletic trainer at each WIAC university.  The head athletic trainer or primary football athletic trainer was provided with a link to an individualized Qualtrics survey with questions pertaining to reported football related concussions at their university between 2009- 2013.  Questions included demographics such as number of staff (e.g. licensed athletic trainers, students, coaches etc.), concussion assessment tools utilized, and number of concussions per year from 2009-2013.  Additionally, each concussion reported had a set of specific questions related to mechanism of injury, age, position, date of injury, and SCAT 2/3 symptom scores.  Based on date of injury, researchers collected weather data (mean temperature and average humidity) as a potential predisposing factor. SUMMARY AND CONCLUSIONS  In general, age and mechanism of injury had no significance in relation to number of symptoms, symptom score, and days withheld from activity overall in the ANOVA and post-hoc analyses.  The weather conditions (mean temperature and average humidity) were highly correlated, however, showed no significance as a predisposing factor.  Concussions occurring during games produced higher SCAT 2/3 symptom scores among those concussed compared to concussions occurring during practice.  Running backs had the highest amount of days withheld from activity compared to all other positions among those concussed. Although running backs had a longer recovery time, there was no significant difference in number of symptoms on a SCAT 2/3.  Defensive linemen and linebackers with reported scores showed a higher significance in relation to number of symptoms on the SCAT 2/3 following a concussion.  Future studies need to include both concussed and non-concussed athletes to provide a more reliable and conclusive data set on rate of concussion in the college football population.  Future studies should explore the validity of the SCAT 2/3 concussion assessment tool as a determinant of days withheld from activity related to increased symptom scores.  Future research should be done to determine whether or not the acknowledgement of predisposing factors will help to decrease rate of concussion and improve preventative strategies. METHODS Subjects  Total of three WIAC football programs participated in the study.  Ages ranging between 18-25 years old (average of 20.3 years).  All football licensed athletic trainers provided electronic informed consent as approved by the Institutional Review Board for the University of Wisconsin – Eau Claire. RESULTS We would like to thank all of the participating WIAC athletic trainers for their participation in our study. We would also like to thank Dr. Braun, Dr. Stow, and Dr. Goodman for their collaboration and assistance in completing this project. ACKNOWLEDGMENTS PURPOSE STATISTICAL ANALYSIS Descriptive statistics were used to create one-way ANOVA analyses and post-hoc analyses to test the relationship of differing predisposing factors to the number of concussions among the population. For the one-way ANOVA, the independent variable was type of activity (game, practice etc.) and the dependent variables were number of symptoms, symptom score, and days withheld from activity. Statistical significance was set at p<0.05. Statistical analyses were performed using SPSS version 19.0 (SPSS Inc.). Table 1. General Population Characteristics BACKGROUND  1.6-3.8 million sport-related concussions are reported annually in the United States. 1  In general, the temporal part of the head is most often affected in regard to a concussion injury which contributes to the impairment of memory, auditory perception, and emotional response. 6  13.3% of all NCAA male athletes reported having at least one concussion compared to 9.9% in the female population. Additionally, division III (5.5%) athletes showed a higher prevalence of multiple concussions compared to division I (4.5%) and division II (4.4%). 2  Football, along with women’s soccer and ice hockey, are among the top three sports with the highest concussion rates. 2  The literature related to concussion injury shows consistent information on mechanism of injury (MOI) and age as predisposing factors of concussion. MOI is most commonly attributed to contact with another player or contact with the playing surface. The highest risk age group is between 13-19 due to aspects of development. 1,3,4,5  The recognition of predisposing factors may further the knowledge and understanding of health care professionals in regard to underlying mechanisms of injury and preventative strategies. The purpose of this study is to determine whether predisposing factors affect an athlete’s susceptibility of a concussion and increase concussion rates among Division III NCAA WIAC football players. Based on past literature, we hypothesized that the predisposing factors of football position and environmental factors would show a direct correlation to the rate of concussion over the fixed timespan. Total Population University 1University 2University 3 # of LATs with football 5221 # of Football Coaches 28810 # of Strength & Conditioning Specialists with football 5131 Concussion Assessment Tools ImPACT, SAC, SCAT2/3 ImPACT & SAC ImPACT & SCAT2/3 TotalUniversity 1University 2University 3 Total # of Concussions71243215 Table 2. Number of Concussions per University *Defensive linemen were excluded due to unreported symptoms