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Updated: Jan 22, 2026

Autonomic Function Following Concussion in Youth Athletes: An Exploration of Heart Rate Variability Using 24-hour Recording Methodology
Published on: September 21, 2018
Increasing Incidence of Concussion: True Epidemic or Better Recognition?
Laura Langer1, Charissa Levy, Mark Bayley
1Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (Ms Langer and Dr Bayley); Toronto ABI Network, GTA Rehab Network, Toronto, Ontario, Canada (Ms Levy); and Institute of Health Policy, Management and Evaluation (Ms Levy) and Division of Physiatry (Dr Bayley), University of Toronto, Toronto, Ontario, Canada.
Objectives:
To provide updated estimates of the incidence of concussion from all causes diagnosed by all physicians in a large jurisdiction, as previous studies have examined only single causes of injury or from smaller specific populations.
Design:
Physician Billing and National Ambulatory Care Reporting System (NACRS) databases were used to identify all Ontario residents with a diagnosis of concussion (ICD-9 850.0 and ICD-10 S06.0) made by physicians between 2008 and 2016, excluding those with moderate to severe traumatic brain injury.
Results:
In total, 1 330 336 people were diagnosed with a concussion between 2008 and 2016. The annual average was 147 815, and 79% were diagnosed in the emergency department. The average annual incidence was 1153 per 100 000 residents. Incidence varied by age, sex, and geography; children younger than 5 years had the highest incidence of concussion, more than 3600 per 100 000 individuals of that age group. Males had higher incidence than females except in older than 65 years age groups. There was a Pearson correlation (+0.669) between sustaining a concussion and living in rural locations.
Conclusion:
The annual incidence of approximately 1.2% of the population is the highest rate of concussion ever reported thorough sampling methods and may represent a closer estimate of the true picture of concussion. Findings may inform future concussion treatment and healthcare planning.
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