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Buyer Beware (Part 1): Claims That Equipment Can Prevent Concussions Too Good To Be True

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It seems that not a day goes by without news about a new product that supposedly reduces the risk of concussion.

Almost invariably, it turns out that the manufacturer's claims are not supported by peer-reviewed scientific evidence.  But that doesn't seem to stop most of them, until, at least, their claims attract the attention of the Federal Trade Commission. Youth football game at line of scrimmage

Just days after the FTC barred mouth guard manufacturer Brain-Pad from claiming that its mouthguard reduced the risk of concussion, a press release on PR Newswire appeared touting supplemental helmet protective pads from a company called Unequal Technologies utilizing what it calls CRT (Concussion Reduction Technology).  The article bears the headline, "2,000 Youth Football Players Converge on Cowboys Stadium; UNEQUAL Technologies Helps Protect Participants from Head Injuries at Battle X 2012."  

Wow! Somehow I missed the news that there is finally, after all these years, a product that prevents head injuries.

Well ... not so fast.

The article goes on to talk about a partnership between Unequal and Pride Youth Football Club, the youth football organization based in Forney, Texas which hosted the Cowboys Stadium event, as being prompted at least in part by the fact that, according to Don Vrana, Pride's president, membership in youth football was down 20 percent nationwide this year.

"We can't lose our athletes to fear of injury," Vrana admitted, "and Unequal is leading the charge in protecting players."  Vrana goes on to say that Pride "partnered with Unequal because we understand the importance of introducing youth to CRT and preventative protective gear at an early age."

But the article begs the question: Where's the proof that Unequal's pads may prevent concussions?

I suggest that there is none. 

The carefully worded press release states that Unequal's products, including its "protective head armor,"  "produce superior shock-blocking properties that may help dramatically reduce impact shock, and that they have  "been tested by independent accredited laboratories, OEM facilities and top universities."  What the release doesn't say, however, is much more important; it doesn't say that a peer-reviewed study has been conducted which supports the thrust of its marketing message: that its helmet pads actually protect a player from concussion or reduce the concussion risk.

I could be wrong, but I suspect that the reason is that no such scientifically-valid study exists.

What I find most distressing, having covered the subject of concussions in youth sports in depth for the past 12 years here on MomsTEAM, is that Pride and Unequal, in trying to calm the fears of football parents about the risk of concussion - the former to stem the drop in participation and the latter in order to sell more products - appear to be intentionally lulling them into a false sense of security about football's safety.  In other words, that if only their child were to wear Unequal's "protective head armor"  they could go into battle on the gridiron without fear of injury.  In my view, that not only comes uncomfortably close to - if not crosses the line - between sales puffery and false advertising, and borders on being downright irresponsible. 

The proof, as they say, is in the pudding.  The fact is that NO mouth guard, football helmet, helmet padding or soccer headband has yet been shown to reduce the risk of concussion. Until there is convincing evidence that they do, MomsTEAM and I will continue to call out equipment manufacturers who suggest, like Unequal, that their product does just that, and provide all youth sports stakeholders with the best and most objective concussion information on the Internet. 

And, when the line between sales puffery and false advertising is crossed, I sure hope that the FTC, as it did with Brain-Pad, is ready to step in to protect consumers.

Until then, my advice to parents is, Buyer beware!

January 31, 2013 update: Unequal Technlogies' CEO, Rob Vito, told ABC New's expose on "Nightline", that his company only claims to "help reduce the possibility of head injury," adding, "We never mention the word 'concussion,'" although the product's name is "Concussion Reduction Technology."

"There might be some confusion," Vito acknowledged to ABC News, maintaining that his company is not claiming its product reduce concussions, saying, "One is a name and one is a claim and our claim is that we help reduce the possibility of head injury."

But, after the ABC News interview, Unequal Technologies sent "Nightline" what it said would be the new packaging for its product, which now just says "CRT," with the words "Concussion Reduction Technology" removed.

All I can say is, it's about time. 

March 28, 2013 update: Three new studies1,2,3 issued in March 2013 all conclude, to one degree or another, that evidence that mouth guards and helmets reduce concussion risk is still lacking:

  • A critical review of the literature1 reported in the British Journal of Sports Medicine concluded that "new evidence suggesting that custom-fitted mouth guards protect players from concussion in American football was limited," and that the "effect of helmet/headgear use on concussion risk is still inconclusive in rugby, football (soccer), ice hockey, American football and rodeo, although the use of helmets in ice hockey and American football have been shown to play an important role in the prevention of skull fracture and severe traumatic brain injury."
  • Writing in the same issue of the BJSM,2 the authors of the 4th Consensus Statement on Concussion in Sport concluded that  there was "no good clinical evidence that currently available protective equipment will prevent concussion, although mouthguards have a definite role in preventing dental and orofacial injury." They went on to note that "[b]iomechanical studies have shown a reduction in impact forces to the brain with the use of head gear and helmets, but these findings have not been translated to show a reduction in concussion incidence."
  • Last, but not least, the authors of the American Academy of Neurology's new evidence-based guidelines for the evaluation and management of concussion in sports, writing in the AAN journal Neurology3  concluded that there was "no compelling evidence that mouth guards protect athletes from concussion," and that data was "insufficient to support or refute the superiority of one type of football helmet in preventing concussion."  Interestingly, in a departure from the conclusion reached by researchers in the other studies, they found it "highly probable that headgear use has a protective effect on concussion incidence in rugby."

 A careful parsing of the language the three studies used ("no compelling evidence," "insufficient to support," "no good clinical evidence,"  evidence is "inconclusive") suggests that we may be inching closer to the day when such evidence is available.  Stay tuned.

1.  Benson B, McIntosh A, Maddocks D, Herring S, Raftery M, Dvorak J.  What are the most effective risk-reduction strategies in sport concussion.  Br J Sports Med 2013;47:321-326.

2. McCrory P, et al.  Consensus statement on concusison in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med 2013;47:250-258.

3. Giza C, Kutcher J, Ashwal S, et al.  Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013 (published online ahead of print March 18, 2013); DOI: 10.1212/WNL.ob013e31828d57dd. 

Brooke de Lench is the Founder and Publisher of MomsTEAM.com and the author of Home Team Advantage: The Critical Role of Mothers in Youth Sports.

Do you know of a product that claims to reduce or prevent concussions? I want to hear about it.  Email the link to delench@MomsTEAM.com.