PROVIDENCE, R.I. [Brown University] — A recent study in which Brown University and the seven other Ivy League institutions participated showed that reducing kickoff returns in which players actively try to advance the ball during football games could lessen the number of concussions players suffer on the field.

Results from the study, published this month in the Journal of the American Medical Association, show a sharp decrease in the rate of concussions following the Ivy League’s decision in 2016 to adopt an experimental kickoff rule in league play. Between 2013 and 2015, data show, about 11 concussions occurred for every 1,000 kickoffs. In 2016 and 2017, after the league shifted the kickoff position and the touchback line, the rate of concussions during kickoffs decreased to about 2 in 1,000.

Though the JAMA study published on Oct. 1, its preliminary data prompted the National Collegiate Athletic Association to adopt a kickoff rule change — distinct from the Ivy League’s rule, but with the same intent — for all levels of football for 2016. The study comes months after new National Football League data were released showing that the concussion rates had reached an all-time high in the 2017 season, prompting continued focus on the physical and cognitive effects of head injuries in football.

“Concussions in football are a nationwide concern,” said Phil Estes, Brown’s head football coach. “Players are bigger, faster and stronger than ever before, and that creates more collisions. We in the Ivy League recognize that the sport must adapt to reflect these changes, and we are proud to take part in research that will help make football safer.”

A team of researchers at the University of Pennsylvania, Princeton University and the Ivy League authored the JAMA study. Their data demonstrate that kickoffs are a logical place to start in the quest to reduce the rate of concussions: while kickoffs comprised less than 6 percent of plays in Ivy League games between 2013 and 2015, nearly a quarter of all concussions came during those plays. Kickoff returns, in which one team catches the other’s kick and runs up the field toward the end zone, can leave players more vulnerable to injuries largely due to their running speed upon impact, explained Matt Culp, Brown’s head athletic trainer.

“The kicking team is spread out across the field and running fast, gathering lots of speed as they head toward the receiving team,” Culp said. “In contrast, during regular line-of-scrimmage play, players tend to stay in a more compact formation and may only run 10 to 15 yards down the field.”

Talk of reducing kickoff-related concussions in Ivy League play began earlier in the decade, when a committee of coaches, medical professionals, university administrators and others reviewed nationwide concussion data and research. The investigation not only led Ivy League schools to increase the use of padding and decrease player-on-player contact during football practices, but also to more formal research on the rate of concussion.

When that research revealed the high rate of kickoff-return concussions, the Ivy League responded by implementing a new set of experimental rules for intraleague play. Starting in 2016, the league determined, teams would kick off from the 40-yard line rather than the 35-yard line — increasing the kicking team’s chances of landing the ball in the end zone, where returning teams often opt to kneel for a “touchback.” The league also moved the touchback line to the 25-yard line rather than the 20-yard line, providing the receiving team with more incentive to simply catch the ball and kneel rather than run the ball up the field.

Data from the JAMA study show that after 2016, about 48 percent of kickoffs resulted in touchbacks — a stark contrast to the pre-2016 touchback rate of just 17.9 percent.

Culp is glad to see that the new rules have decreased the rate of active kickoff returns and helped to curb concussions, which can be one of the most difficult football injuries to identify and treat. On the field, Culp and his colleagues use the SCAT5 test to determine whether a player has suffered a concussion. The test involves a 22-symptom checklist, a demonstration of balance, a neurological screen and a series of memory-related questions.

“We don’t yet have a definitive biomarker, like a saliva or blood test, to give us a cut-and-dried answer,” Culp said. “Research has come a long way, but there’s still no gold standard for assessing a concussion.”

The injury’s effect on student-athletes can be particularly far-reaching, Estes said, as it can hamper not only their athletic performance but also their academic progress.

“Concussions can be debilitating, not just at the time of the concussion and in the months afterward, but also later in life,” Estes said.

Estes, who helped his son Brett recover from two football concussions in high school, has become a strong advocate for safer play in every realm of football, from Pop Warner youth leagues to professional teams.

“I think the game will continue to evolve and become safer,” Estes said, “And I hope Brown and the Ivy League continue to be at the forefront of making all sports safer for student athletes.”