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Research

Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39342.690220.55 (Published 18 October 2007) Cite this as: BMJ 2007;335:809
  1. Mike Loosemore, lead sports physician1,
  2. Charles H Knowles, clinical senior lecturer and honorary consultant surgeon2,
  3. Greg P Whyte, professor of sport and exercise science3
  1. 1English Institute of Sport, London Region, Olympic Medical Institute, Northwick Park Hospital, Harrow HA1 3UJ
  2. 2Barts and the London NHS Trust and the Homerton University NHS Foundation Trust, Centre for Academic Surgery, Royal London Hospital, London E1 1BB
  3. 3Research Institute for Sport and Exercise Sciences, Liverpool John Moores University
  1. Correspondence to: M Loosemore mike.loosemore{at}eis2win.co.uk
  • Accepted 7 August 2007

Abstract

Objective To evaluate the risk of chronic traumatic brain injury from amateur boxing.

Setting Secondary research performed by combination of sport physicians and clinical academics.

Design, data sources, and methods Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE).

Results 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied.

Conclusion There is no strong evidence to associate chronic traumatic brain injury with amateur boxing.

Footnotes

  • Contributors: ML and CK made substantial contributions to conception and design of the study, acquisition, analysis, and interpretation of data, and drafting and revising the article. GW critically revised the article for important intellectual content. All authors gave final approval of the version to be published. ML is guarantor.

  • Funding: None.

  • Competing interests: ML is lead sports physician (London Region) at the English Institute of Sport, Olympic Medical Institute, and physician to the British Amateur Boxing Team. ML and CK are commissioners on the ABA of England Medical Commission.

  • Ethical approval: Not required.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

  • Accepted 7 August 2007
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