RT Journal Article SR Electronic T1 Primary prevention of contact sports-related concussions in amateur athletes: a systematic review from the Eastern Association for the Surgery of Trauma JF Trauma Surgery & Acute Care Open FD BMJ Publishing Group Ltd SP e000153 DO 10.1136/tsaco-2017-000153 VO 3 IS 1 A1 Toby M Enniss A1 Khaled Basiouny A1 Brian Brewer A1 Nikolay Bugaev A1 Julius Cheng A1 Omar K Danner A1 Thomas Duncan A1 Shannon Foster A1 Gregory Hawryluk A1 Hee Soo Jung A1 Felix Lui A1 Rishi Rattan A1 Pina Violano A1 Marie Crandall YR 2018 UL http://tsaco.bmj.com/content/3/1/e000153.abstract AB Background Awareness of the magnitude of contact sports-related concussions has risen exponentially in recent years. Our objective is to conduct a prospectively registered systematic review of the scientific evidence regarding interventions to prevent contact sports-related concussions.Methods Using the Grading of Recommendations Assessment, Development, and Evaluation methodology, we performed a systematic review of the literature to answer seven population, intervention, comparator, and outcomes (PICO) questions regarding concussion education, head protective equipment, rules prohibiting high-risk activity and neck strengthening exercise for prevention of contact sports-related concussion in pediatric and adult amateur athletes. A query of MEDLINE, PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature, and Embase was performed. Letters to the editor, case reports, book chapters, and review articles were excluded, and all articles reviewed were written in English.Results Thirty-one studies met the inclusion criteria and were applicable to our PICO questions. Conditional recommendations are made supporting preventive interventions concussion education and rules prohibiting high-risk activity for both pediatric and adult amateur athletes and neck strengthening exercise in adult amateur athletes. Strong recommendations are supported for head protective equipment in both pediatric and adult amateur athletes. Strong recommendations regarding newer football helmet technology in adult amateur athletes and rules governing the implementation of body-checking in youth ice hockey are supported.Conclusion Despite increasing scientific attention to sports-related concussion, studies evaluating preventive interventions remain relatively sparse. This systematic review serves as a call to focus research on primary prevention strategies for sports-related concussion.Level of evidence IV.PROSPERO registration number #42016043019.