Incidence of concussion in intercollegiate wheelchair basketball athletes

BACKGROUND: Concussion surveillance in adaptive sports is essential for improving athlete safety and informing prevention strategies, yet existing data remain limited. To our knowledge, this is the first longitudinal investigation of concussion incidence in athletes with disability across multiple seasons. OBJECTIVE: To determine the incidence of sport-related concussion in collegiate wheelchair basketball across multiple seasons and compare rates with National Collegiate Athletic Association (NCAA) basketball athletes without disabilities. DESIGN: Prospective, multiseason, longitudinal surveillance cohort study. SETTING: The University of Texas at Arlington men's and women's wheelchair basketball teams. INTERVENTIONS: Repeated administration of standardized electronic injury and illness surveys pre-, intra-, and post season. Concussion reporting through both athlete self-report surveys and athletic trainer verified injuries. MAIN OUTCOME MEASURES: Concussion rates of intercollegiate wheelchair basketball athletes across seasons per 10,000 athlete exposures, injury rate ratios compared to NCAA basketball athletes without disabilities, and injury descriptive statistics on mechanism of injury, time missed, and care received. RESULTS: Twelve concussions occurred across four seasons (2021-2024, 99 athlete-seasons). Concussion rate per 10,000 athlete exposures were 6.66 (95% confidence interval, 2.44-14.49), 8.86 (3.25-19.29), and 7.60 (3.93-13.28) for men, women, and combined, respectively. Compared to NCAA basketball, injury rate ratios were 1.99 (0.88-4.49), 1.69 (0.75-3.80), and 1.79 (1.01-3.18) for men, women, and overall, indicating a significantly higher overall rate of concussion. CONCLUSIONS: Across a multiseason longitudinal study, collegiate wheelchair basketball players experienced a higher overall concussion rate than their collegiate basketball (NCAA) counterparts without disabilities. These findings emphasize the need for improved surveillance, targeted concussion prevention, and tailored response protocols in adaptive sports.