Concussions Analysis in 2022-2024 CONMEBOL Soccer Tournaments

Osvaldo Pangrazio¹Francisco Forriol¹Alex S. Aguirre²Tina Bastin³Alcy R. Torres^3*

• ¹South American Football Confederation, Luque, Paraguay
• ²Boston Children's Hospital, Harvard Medical School, Boston, United States
• ³Boston University Chobanian & Avedisian School of Medicine, Boston, United States

Introduction: Sports-related concussions (SRC) are a pressing global health concern. However, countries in the Global South often lack standardized diagnostic criteria, and limited medical resources lead to inconsistent SRC detection. Our study presents a culturally adapted concussion detection protocol implemented by the region's governing soccer federation, CONMEBOL. Methods: The Concussion Fast Recognition Protocol (CFRP) was developed by adapting the Sport Concussion Assessment Tool, the Standardized Assessment of Concussion, and incorporating community-level input to ensure cultural relevance. The protocol was written in English, Spanish, and Portuguese. On-field medical teams completed the CFRP after each CONMEBOL match (N=156) from 2022 to 2024, regardless of whether an SRC occurred. Players included in the study (N=5,928) ranged in age from 15-44 years. Results: A total of 27 concussions were identified, all of which were immediately removed from play. Most concussions (37.04%) occurred during the 21-45-minute period, and 59.26% involved away-team athletes. The incidence rate per 1,000 player-hours was 2.61. Game temperatures ranged from 7°C to This is a provisional file, not the final typeset article 36°C, and the maximum altitude reached 4,150 meters. The distance covered by players ranged from 550 to 6100 meters. Incidence rates per 1,000 player-hours were calculated. Discussion: This first large-scale, prospective SRC study in South American soccer demonstrates effective implementation of a regional protocol and identifies context-related trends in SRC risk. The findings underscore the importance of a culturally appropriate protocol and contribute novel data to global concussion literature.