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Study Finds Concussions Prevalent Among H.S. Water Polo Players

Nearly a third of water polo players who only played the sport in high school reported suffering at least one concussion during practice or a game, according to a study published online last month in the journal Frontiers in Neurology.

Researchers from the University of California-Irvine surveyed more than 1,500 members of USA Water Polo to assess the prevalence of concussions and significant head impacts in the sport. Based on the responses, they determined "competition level, gender, and field position" to be "robust predictors of concussion risk," noting that goalies are "at significantly higher risk for concussion."

Among the 606 respondents whose water polo careers ceased after high school, 193 reported suffering at least one concussion during play (31.8 percent). Those who reported at least one concussion estimated having suffered an average of 1.6 concussions during their respective water polo careers.

Of the 199 respondents who continued playing water polo in college but progressed no further than that, 102 reported having suffered at least one concussion (51.5 percent). The average number of concussions among that group was 2.3.

Among water polo players of all ages, females had a far higher prevalence of concussions (257-of-602, or 43.5 percent) than males (266-of-889, or 30.8 percent). Both genders reported a nearly identical average number of concussions, though—2.1 for females and 2.2 for males. In terms of position, goalies by far had the highest concussion rate (120-of-255, or 47.1 percent). No other position had a lifetime concussion prevalence above 40 percent. Goalies also reported the highest number of average concussions (2.5) of any position.

"These numbers suggest that playing water polo carries a significant risk of concussion," said Dr. Steven L. Small, one of the study's authors and a professor and the chair of neurology at the University of California-Irvine, in a statement. "Our results speak to the need for systematic concussion reporting in water polo. Particularly important is reporting for individuals at the college level, who have the highest prevalence of concussion."

Respondents were also asked to assess how many "serious blows to the head" they suffered while playing water polo, even if they didn't think it resulted in a concussion. Across all respondents, they estimated having suffered 10.67 serious head impacts, plus or minus 1.61. There was a correlation between the amount of serious head impacts and the number of years someone played water polo, with those who played for longer (perhaps unsurprisingly) reporting more head impacts.

The study authors noted that they received responses from fewer than 4 percent of the estimated water polo players across the country, which limits their ability to claim their findings are representative of all water polo players. Because the survey was "internet-based, self-report, self-selecting, and relied on participants' memory for events," including subject definitions of concussions, the authors could not "rule out the possibility of systematic bias or the over-reporting of concussions."

Despite those limitations, the authors believe their findings speak to a need for more systematic concussion reporting in water polo, particularly for individuals at the college level. Given goalies' increased concussion risk, they also recommended finding "a means of reducing or mitigating harm during practice," such as greater head protection.

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