Concussion occurrence and recognition in professional boxing and MMA matches: toward a concussion protocol in combat sports

ABSTRACT

Objectives: Determine, through video reviews, how often concussions occur in combat sport matches, what influence they have on the outcome, and how well non-physician personnel can be trained to recognize concussions.

Methods: This is a retrospective video analysis by an 8-person panel of 60 professional fights (30 boxing and 30 mixed martial arts). Through video review, physician and non-physician personnel recorded details about each probable concussion and determined if and when they would have stopped the fight compared to the official stoppage time.

Results: A concussion was recorded in 47/60 fights. The mean number of concussions per minute of fight time was 0.061 (0.047 for boxers and 0.085 for MMA). When stratifying by outcome of the bout, the mean number of concussions per minute for the winner was 0.010 compared to the loser at 0.111 concussions per minute. The fighter that sustained the first concussion ultimately lost 98% of the time. The physician and non-physician raters had high agreement regarding the number of concussions that occurred to each fighter per match. The physician raters judged that 24 of the 60 fights (11 boxing [37%]; 13 MMA [43%]) should have been stopped sooner than what occurred.

Conclusion: Recognizing that the concussions often occur in combat sport matches, that the losing fighter almost always is concussed first and tends to sustain more concussions during the fight, along with the demonstration that non-physician personnel can be taught to recognize concussion, may guide policy changes that improve brain health in combat sports.

KEYWORDS:

• Concussion
• traumatic brain injury
• video analysis

Acknowledgments

We appreciate the contribution of Todd Neal and Gary Thomas in reviewing and judging fight videos for this project.

Contributors

CB, TH, TS were involved in design of the study; CB, TH, TS, VW, MG, BN, WN assisted in data collection, GS provided statistical analyses for the paper; CB generated the initial draft of the paper; CB, TH, WN, VW, MG, BN, TS, GS revised the subsequent versions of the paper and approved the final version

Declaration of interest

CB has received research support from the UFC, Haymon boxing, Top Rank Promotions.

Data sharing

Data will be provided upon reasonable request.

Patient consent

None required

Additional information

Funding

This research has not been funded by any specific funding agency in the public, commercial, or non-profit sector.