| Yang 2005 Cluster cohort study (USA) | Random selection; 100 schools; stratified according to size and region; 19 728 athlete seasons (1 104 354 athlete exposures); grades 9–12; from 6 male sports and 6 female sports in each school (sport selected using systematic sampling). | (A) Protective equipment: any self-reported use of discretionary protective equipment not required by sports rules. (B) Control: self-reported non-use of discretionary protective equipment. (Self-reported compliance: questionnaire). | Injury definition: any new injury sustained between hip and toe that required medical attention or restricted participation on the day after the injury. Severity classification: (1) “no time lost to participation”; (2) mild injury, <1 week lost; (3) moderate injury, <3 weeks lost; (4) serious injury, lost more than 3 weeks. (3 year period). Authors’ conclusion: inconclusive: use of lower limb discretionary equipment has variable effect on injury rate and severity, | Data collection methods: 4 questionnaires, administered during the season by trained member of school staff. Injury verification: not described. |
| McIntosh 2001 Pilot prospective intervention study, cluster randomisation (Australia) | 294 male rugby union players (age under 15 A grade) from 6 schools (schools volunteered to participate in study). Randomisation by teams (total of 16 teams) to intervention and control groups. | (A) Headgear: 1179 exposures with headgear (9 teams). (B) Control: 357 exposures without headgear (7 teams). (Participation and headgear use documented by recording officer at each school. Checked at random by investigators). | Injury definition: a traumatic event that resulted in the player missing game playing or training time. Authors’ conclusion: negative: current headgear does not provide significant protection against concussion in junior level rugby union. | Data collection methods: nominated “recording officer” for each team documented details of head injury for each game. Injury verification: team medical officers contacted to verify diagnosis. |
| Webster 1999 Prospective cohort study (USA) | 700 high school lacrosse players (all female aged 13–18) | (A) Goggles: 51 376 exposures. (B) No goggles: 77 947 exposures. Note: allocation to groups based on voluntary use. | Injury definition: all reported injuries involving eyes, face, scalp, skull, ears and jaw to trainer, coach, nurse or other officials. Severity classification: according to injury site, mechanism, type and severity. (no details provided). Authors’ conclusion: positive: the use of protective eyewear is beneficial in preventing injury in women’s lacrosse. | Data collection methods: collected by coaches + athletic trainers, nurse and other officials on data reporting forms. Follow-up information requested 2–4 weeks after initial report to assess seriousness of injury. Injury verification: not described |
| Grace 1988 Prospective cohort study (matched pair) (USA) | 580 (694) male high school varsity + junior varsity footballers. | (A) Knee brace: 330 athletes in knee braces (247 single hinged brace, 83 single-upright double hinged brace). (B) Control: 250 non-braced players matched for height, weight and playing position. | Injury definition: mild, less than 1 day of participation lost; minor (grade 1), loss of <7 days; moderate (grade II), 7–20 days lost; major (grade III), ⩾21 days lost. (2 year study period). Authors’ conclusion: negative: braces did not reduce incidence of knee injuries, and were associated with increased injuries of ankle and foot on same side as knee injury. | Data collection methods: injuries of lower extremity + treatment documented during the season by school’s full time athletic trainer. Injury verification: injuries diagnosed and managed by school doctors (voluntary). |