Jugular Venous Compression Collar for Prevention of Brain Injury due to Repetitive Head Impact and Concussion in Sport: A Scoping Review.

CONTEXT: There is significant interest in jugular venous compression (JVC) devices from multiple parties, including sports physicians, athletic trainers, athletes, and parents.

OBJECTIVE: To examine the effects of JVC on repetitive head impacts and evaluate their effectiveness in reducing brain injury and concussion risk in sport.

DATA SOURCES: Embase, Cochrane Central Register of Controlled Trials, CINAHL Plus, SPORTDiscus, Web of Science Core Collection - SCI-EXPANDED, SSCI, AHCI, ESCI, American Psychological Association, PsycInfo, WHO International Clinical Trials Registry Platform (ICTRP), ProQuest Dissertations and Theses Citation Index (Web of Science), Europe PMC, and PubMed.

STUDY SELECTION: Full-text, peer-reviewed manuscripts of primary research, published between 2010 and 2024.

DATA EXTRACTION: A total of 22 articles met the inclusion criteria. These articles were categorized into 4 groups: animal models (n = 4), biomechanics in humans (n = 4), evidence in athletes (n = 11), and evidence in Special Weapons and Tactics Breacher Training (SWAT) (n = 3). Several of the athlete articles used the same cohort of athletes.

RESULTS: There was no difference in concussion rates in athletes between collared and noncollared groups during a season, while evidence from animal and tactical populations was limited to mechanistic and imaging outcomes. In both athletes and SWAT personnel, there were no clinically significant differences in neurocognitive performance between groups. There are statistically significant imaging changes between collared and noncollared groups; however, the imaging changes were not consistent and are of uncertain clinical significance. Furthermore, 6 out of 11 studies in athletes are currently under investigation. The available evidence supports that JVC can increase intracranial pressure, but it remains unknown if this results in any clinically meaningful benefit.

CONCLUSION: Although no adverse outcomes are reported with collar use, current research does not support the effectiveness of JVC collars for concussion reduction and use for mitigation of repetitive head impact. Additional studies from diverse research teams with independent funding sources are required.

STUDY DESIGN: Scoping review.

LEVEL OF EVIDENCE: Level 5.