Retrospective report on the effectiveness of a polyurethane football helmet cover on the repeated occurrence of cerebral concussions

Am J Orthop (Belle Mead NJ). 1999 Feb;28(2):128-32.


This report reviews the literature and unpublished data and presents survey results related to the use of a polyurethane football helmet cover. Two hundred forty-five individuals, identified by the helmet manufacturer as having purchased at least one device, were sent a survey after the 1992, 1993, and 1994 football seasons; 155 (63.3%) of the surveys were returned. The questionnaire, designed to be completed by the athlete, required a detailed history of concussions occurring both prior to and during the period the device was used. Individuals used the device as a result of having incurred at least one concussion. Rates of concussion reoccurrence while the device was worn were grouped by the number of previous concussions (1, 2, 3, or 4+) that occurred over a 4year period prior to use of the device. The rate of concussion reoccurrence was 2.4%, 7.3%, 15.8%, and 33.3%, respectively, over a 4-year period. The range appeared to reflect a parallel relationship between pre- and post-device concussion experiences: the more concussions experienced prior to adopting the device, the higher the rate of concussion reoccurrence while using the device. The natural history of repeated occurrences of concussive events may not be affected by the use of a polyurethane football helmet cover. We suggest that such a device not be routinely used prophylactically, but instead be reserved for individuals with 1 to 2 prior concussion injuries. However, at this time, we neither recommend nor discommend the device.

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / prevention & control*
  • Brain Concussion / prevention & control*
  • Head Protective Devices*
  • Humans
  • Male
  • Materials Testing
  • Polyurethanes
  • Retrospective Studies
  • Secondary Prevention


  • Polyurethanes