Differences in sport-related concussion for female and male athletes in comparable collegiate sports: a study from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium

2020 ◽  
pp. bjsports-2020-103316
Author(s):  
Christina L Master ◽  
Barry P Katz ◽  
Kristy B Arbogast ◽  
Michael A McCrea ◽  
Thomas W McAllister ◽  
...  
Keyword(s):  
Sex Differences ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Extrinsic Factors ◽  
Contact Sports ◽  
Recovery Times ◽  
Division Ii ◽  
Concussion Recovery ◽  
Research And Education ◽  
Assessment Research

ObjectivesTo examine sex differences in sport-related concussion (SRC) across comparable sports.MethodsProspective cohort of collegiate athletes enrolled between 2014 and 2017 in the Concussion Assessment, Research and Education Consortium study.ResultsAmong 1071 concussions (females=615; 57.4%), there was no difference in recovery (median days to full return to play) (females=13.5 (IQR 9.0, 23.1) vs males=11.8 (IQR 8.1, 19.0), p=0.96). In subgroup analyses, female recovery was longer in contact (females=12.7 days (IQR 8.8, 21.4) vs males=11.0 days (IQR 7.9, 16.2), p=0.0021), while male recovery was longer in limited contact sports (males=16.9 days (IQR 9.7, 101.7) vs females=13.8 days (IQR 9.1, 22.0), p<0.0001). There was no overall difference in recovery among Division I schools (females=13.7 (IQR 9.0, 23.1) vs males=12.2 (IQR 8.2 19.7), p=0.5), but females had longer recovery at the Division II/III levels (females=13.0 (IQR 9.2, 22.7) vs males=10.6 (IQR 8.1, 13.9), p=0.0048).ConclusionOverall, no difference in recovery between sexes across comparable women’s and men’s sports in this collegiate cohort was found. However, females in contact and males in limited contact sports experienced longer recovery times, while females had longer recovery times at the Division II/III level. These disparate outcomes indicate that, while intrinsic biological sex differences in concussion recovery may exist, important, modifiable extrinsic factors may play a role in concussion outcomes.

scholarly journals Reconsidering Return-to-Play Times: A Broader Perspective on Concussion Recovery

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876085 ◽  
Author(s):  
Christopher D’Lauro ◽  
Brian R. Johnson ◽  
Gerald McGinty ◽  
C. Dain Allred ◽  
Darren E. Campbell ◽  
...  
Keyword(s):  
Recovery Time ◽  
Time Window ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Sample Population ◽  
Intercollegiate Athletes ◽  
Level Of Evidence ◽  
Athletic Status ◽  
Recovery Times ◽  
Concussion Recovery

Background: Return-to-play protocols describe stepwise, graduated recoveries for safe return from concussion; however, studies that comprehensively track return-to-play time are expensive to administer and heavily sampled from elite male contact-sport athletes. Purpose: To retrospectively assess probable recovery time for collegiate patients to return to play after concussion, especially for understudied populations, such as women and nonelite athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Medical staff at a military academy logged a total of 512 concussion medical records over 38 months. Of these, 414 records included complete return-to-play protocols with return-to-play time, sex, athletic status, cause, and other data. Results: Overall mean return to play was 29.4 days. Sex and athletic status both affected return-to-play time. Men showed significantly shorter return to play than women, taking 24.7 days (SEM, 1.5 days) versus 35.5 days (SEM, 2.7 days) ( P < .001). Intercollegiate athletes also reported quicker return-to-play times than nonintercollegiate athletes: 25.4 days (SEM, 2.6 days) versus 34.7 days (SEM, 1.6 days) ( P = .002). These variables did not significantly interact. Conclusion: Mean recovery time across all groups (29.4 days) showed considerably longer return to play than the most commonly cited concussion recovery time window (7-10 days) for collegiate athletes. Understudied groups, such as women and nonelite athletes, demonstrated notably longer recovery times. The diversity of this sample population was associated with longer return-to-play times; it is unclear how other population-specific factors may have contributed. These inclusive return-to-play windows may indicate longer recovery times outside the population of elite athletes.

Sex differences in outcome following sports-related concussion

2005 ◽  
Vol 102 (5) ◽  
pp. 856-863 ◽  
Author(s):  
Donna K. Broshek ◽  
Tanya Kaushik ◽  
Jason R. Freeman ◽  
David Erlanger ◽  
Frank Webbe ◽  
...  
Keyword(s):  
Sex Differences ◽  
Subjective Experience ◽  
Female Athletes ◽  
Collegiate Athletes ◽  
Cognitive Change ◽  
Return To Play ◽  
Cognitive Test ◽  
Content Type ◽  
Baseline Levels ◽  
Fine Print

Object. Females comprise an increasing percentage of the athlete population across all age groups, and analysis of recent literature reveals that they sustain more concussions in collegiate sports. Results of human and animal studies indicate that females may have poorer outcomes after traumatic brain injury; however, no return-to-play guideline takes sex or other individual differences into account. In the present study the authors evaluated the influence of patient sex on objective neurocognitive performance and subjective reporting of symptoms following sports-related concussion. Methods. According to preseason baseline neurocognitive computerized testing in 2340 male and female high school and collegiate athletes, individuals who sustained sports-related concussions (155 persons) were reevaluated using an alternate form of the cognitive test. Sex differences in the magnitude of cognitive change from baseline levels and the subjective experience of symptoms were analyzed. To account for the possible protective effects of helmets, comparisons were performed among females, males with helmets, and males without helmets; none of the female athletes wore helmets. Female athletes had significantly greater declines in simple and complex reaction times relative to preseason baseline levels, and they reported more postconcussion symptoms compared with males. As a group, females were cognitively impaired approximately 1.7 times more frequently than males following concussions. Furthermore, females experienced more objective and subjective adverse effects from concussion even after adjusting for the use of helmets by some groups of male athletes (for example, in football). Conclusions. Return-to-play decisions and concussion management must be objective and made on an individual basis, including consideration of factors such as patient sex rather than relying on a one-size-fits-all guideline.

scholarly journals Adolescents With ADHD Do Not Take Longer to Recover From Concussion

2021 ◽  
Vol 8 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson ◽  
Bruce Maxwell ◽  
Ross Zafonte ◽  
Paul D. Berkner
Keyword(s):  
Recovery Time ◽  
Return To Play ◽  
Return To School ◽  
Prior History ◽  
Return To Sports ◽  
Full Time ◽  
Recovery Times ◽  
Concussion History ◽  
Concussion Recovery ◽  
Medication Status

The objective of this study was to determine whether adolescents with attention-deficit/hyperactivity disorder (ADHD) have prolonged return to school and sports following concussion compared to those without ADHD and whether medication status or concussion history is associated with recovery time. We hypothesized that having ADHD would not be associated with longer recovery time. This prospective observational cohort study, conducted between 2014 and 2019, examined concussion recovery among school sponsored athletics throughout Maine, USA. The sample included 623 adolescents, aged 14–19 years (mean = 16.3, standard deviation = 1.3 years), 43.8% girls, and 90 (14.4%) reported having ADHD. Concussions were identified by certified athletic trainers. We computed days to return to school (full time without accommodations) and days to return to sports (completed return to play protocol) following concussion. Adolescents with ADHD [median days = 7, interquartile range (IQR) = 3–13, range = 0–45] did not take longer than those without ADHD (median days = 7, IQR = 3–13, range = 0–231) to return to school (U = 22,642.0, p = 0.81, r = 0.01; log rank: χ12 = 0.059, p = 0.81). Adolescents with ADHD (median days = 14, IQR = 10–20, range = 2–80) did not take longer than those without ADHD (median days = 15, IQR = 10–21, range = 1–210) to return to sports (U = 20,295.0, p = 0.38, r = 0.04; log rank: χ12 = 0.511, p = 0.48). Medication status and concussion history were not associated with longer recovery times. Adolescents with ADHD did not take longer to functionally recover following concussion. Recovery times did not differ based on whether adolescents with ADHD reported taking medication to treat their ADHD or whether they reported a prior history of concussion.

The Effects of Concussion on Quantity and Quality of Sleep in Football Athletes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S22.1-S22
Author(s):  
Taren Bone ◽  
Suzanne M. Konz ◽  
William Garrett ◽  
Charles Andrew Gilliland
Keyword(s):  
Sleep Disturbances ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Quality Of Sleep ◽  
Time In Bed ◽  
Study Results ◽  
Sleep Parameters ◽  
Concussion Recovery ◽  
Initial Measurement

ObjectiveThe objective was to observe the quantity and quality of sleep of collegiate athletes following a concussion.BackgroundPatients diagnosed with a concussion report a disruption or change in their sleep with 46% of patients still having sleep disturbances 3 months after the event. Research is lacking on the sleep disruption or sleep changes in athletes who have experienced a concussion.Design/MethodsThis IRB-approved convenient cohort study involved athletes from 2 local universities. 27 (20 non-concussed and 7 concussed) male collegiate football players (19.93 ± 1.14 years old, 1.82 ± 0.08 m, and 96.42 ± 21.26 kg) wore a Readiband device for 7–10 days or throughout concussion recovery. Concussed participants completed a symptom score sheet each day. Participants returned the Readiband device and completed the Pittsburgh Sleep Quality Index Questionnaire (PSQIQ) after 7–10 days or on return to play. The sleep parameters, and PSQIQ scores were analyzed using non-parametric & independent t-tests with the alpha level set at 0.05.ResultsThe t-tests indicated a difference between the total minutes in bed at the initial measurement (F = 11.839, df = 1, p = 0.037) between the concussed (353.29 ± 110.48 minutes) and non-concussed (471.5 ± 125.09 minutes) groups. There was also a difference between the total minutes asleep at the initial measurement (F = 12.662, df = 1, p = 0.032) between the concussed (286.43 ± 86.73) and non-concussed groups (383.7 ± 104.86). The last measurement that indicated a difference was the calculated minutes in bed at the initial measurement (F = 11.916, df = 1, p = 0.023) between the concussed (326.4 3 ± 97.01) and non-concussed groups (441.60 ± 110.55).ConclusionsThe study results indicate that concussion affects the quantity of sleep, with concussed athletes spending less time in bed and fewer minutes asleep. Changes in sleep occur post-concussion, which may delay concussion recovery.

scholarly journals The Influence of Hormonal Contraceptives on Cognitive Recovery in Concussed Collegiate Athletes: Data from the NCAA-DoD CARE Consortium

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S14.3-S15
Author(s):  
Jacob Kay ◽  
Andrew Lapointe ◽  
Thomas McAllister ◽  
Michael McCrea ◽  
Steven Broglio ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Female Athletes ◽  
Clinical Symptoms ◽  
Collegiate Athletes ◽  
Neurological Status ◽  
Return To Play ◽  
Hormonal Contraceptives ◽  
Cognitive Efficiency ◽  
Concussion Recovery ◽  
The Impact

ObjectiveTo longitudinally examine the relation between hormonal contraceptives and concussion recovery. We hypothesized that female athletes using hormonal contraceptives would exhibit faster recovery times and smaller post-injury alterations in neurological status, cognition, and clinical symptoms than female athletes not using hormonal contraceptives.BackgroundResearch indicates sex may moderate concussion outcomes, with some females experiencing protracted recovery relative to males. It is hypothesized that fluctuations of sex hormones lead to poorer outcomes in these females. Thus, female athletes taking hormonal contraceptives may exhibit better recovery than their un-medicated counterparts, as their hormone levels are artificially stabilized.Design/MethodsData from the NCAA-DOD Grand Alliance: Concussion Assessment, Research, and Education (CARE) Consortium were used to evaluate female athletes who were (n = 50) and were not (n = 50) taking hormonal contraceptives. Baseline assessments were completed prior to athletes’ sport season. Athletes were re-assessed 24–48 hours post-concussion, and again at the unrestricted return-to-play. Length of recovery was defined as days between injury and the unrestricted return-to-play. Neurological status was measured using the Standardized Assessment of Concussion (SAC). Cognitive function and clinical symptoms were measured using the ImPACT test. Participants were matched on age, sex, body mass index, sport, and concussion history.ResultsNo group differences in length of recovery were observed (p > 0.05). Across all timepoints, analyses revealed main effects of group for concentration (SAC; p = 0.04), verbal memory (ImPACT; p = 0.03), and cognitive efficiency (ImPACT; p = 0.01). No differences in change scores (relative to baseline) were observed between groups.ConclusionsThe current results suggest that hormonal contraceptives do not influence concussion recovery. However, irrespective of injury status, our findings indicate that females on hormonal contraceptives may exhibit better concentration, working memory, and cognitive efficiency.

Discriminative Validity of Vestibular Ocular Motor Screening in Identifying Concussion Among Collegiate Athletes: A National Collegiate Athletic Association–Department of Defense Concussion Assessment, Research, and Education Consortium Study

2021 ◽  
pp. 036354652110123
Author(s):  
Anthony P. Kontos ◽  
Shawn R. Eagle ◽  
Gregory Marchetti ◽  
Aaron Sinnott ◽  
Anne Mucha ◽  
...  
Keyword(s):  
Department Of Defense ◽  
National Collegiate Athletic Association ◽  
Collegiate Athletes ◽  
Ocular Motor ◽  
Predictive Utility ◽  
Ocular Reflex ◽  
Vestibular Ocular Reflex ◽  
Concussion History ◽  
Research And Education ◽  
Assessment Research

Background: Vestibular and ocular motor screening tools, such as the Vestibular/Ocular Motor Screening (VOMS), are recognized as important components of a multifaceted evaluation of sport-related concussion. Previous research has supported the predictive utility of the VOMS in identifying concussion, but researchers have yet to examine the predictive utility of the VOMS among collegiate athletes in the first few days after injury. Purpose: To determine the discriminative validity of individual VOMS item scores and an overall VOMS score for identifying collegiate athletes with an acute sport-related concussion (≤72 hours) from healthy controls matched by age, sex, and concussion history. Study Design: Case-control study; Level of evidence, 3. Methods: Participants (N = 570) aged 17 to 25 years were included from 8 institutions of the National Collegiate Athletic Association–Department of Defense CARE Consortium (Concussion Assessment, Research, and Education): 285 athletes who were concussed (per current consensus guidelines) and 285 healthy controls matched by age, sex, and concussion history. Participants completed the VOMS within 3 days of injury (concussion) or during preseason (ie, baseline; control). Symptoms are totaled for each VOMS item for an item score (maximum, 40) and totaled across items for an overall score (maximum, 280), and distance (centimeters) for near point of convergence (NPC) is averaged across 3 trials. Receiver operating characteristic analysis of the area under the curve (AUC) was performed on cutoff scores using Youden index ( J) for each VOMS item, overall VOMS score, and NPC distance average. A logistic regression was conducted to identify which VOMS scores identified concussed status. Results: A symptom score ≥1 on each VOMS item and horizontal vestibular/ocular reflex ≥2 significantly discriminated concussion from control (AUC, 0.89-0.90). NPC distance did not significantly identify concussion from control (AUC, 0.51). The VOMS overall score had the highest accuracy (AUC, 0.91) for identifying sport-related concussion from control. Among the individual items, vertical saccades ≥1 and horizontal vestibular/ocular reflex ≥2 best discriminated concussion from control. Conclusion: The findings indicate that individual VOMS items and overall VOMS scores are useful in identifying concussion in collegiate athletes within 3 days of injury. Clinicians can use the cutoffs from this study to help identify concussion in collegiate athletes.

scholarly journals An Examination of Concussion Recovery Time in Athletes Ages 13–18

2019 ◽  
Vol 34 (5) ◽  
pp. 739-739
Author(s):  
S Burkhart ◽  
C Ellis ◽  
J Baggett ◽  
T Smurawa ◽  
J Polousky
Keyword(s):  
Recovery Time ◽  
Student Athletes ◽  
One Health ◽  
Athletic Trainers ◽  
Injury Surveillance ◽  
Return To Play ◽  
Rank One ◽  
Recovery Times ◽  
Concussion Recovery ◽  
Surveillance Database

Abstract Purpose The purpose of this study was to examine recovery time from concussion utilizing date of injury and date of return to play. It was hypothesized females would have longer recovery times by age and dual gender sports (baseball/softball, basketball, soccer, swimming/diving, and track/field). Methods This study used data from the Rank One Health Injury Surveillance Database (ROH ISD) between 2012–18, in student-athletes ages 13 to 18. This study examined concussion reporting by Athletic Trainers (ATCs) at both middle schools and high schools. Independent sample t-tests were performed by gender, age (13–15, 16–18), and sport with p < 0.05 being statistically significant. Results A total of 3,967 concussions with an average age of 15.34 (SD = 1.43), with a defined date of injury and date of return to play were recorded by ATCs. There was a significant effect in recovery time for gender, F(1, 3965) = 3.36, p<0.001 with females taking longer to recover than males. There was a statistically significant effect in recovery time for age, F(1, 3965) = 3.97, p<0.001 with athletes ages 13–15 taking longer to recovery than athletes ages 16–18. Females also experienced longer recovery when comparing sports, with significant differences observed in baseball/softball, soccer, swimming/diving, and track/field. Conclusion This study marks the largest examination of recovery time in student athletes ages 13–18. The findings from this study provide further evidence for longer observed recovery time in females compared to males.

scholarly journals The Influence of Psycho-Stimulant Medication on Concussion Recovery in Athletes with ADHD: Findings from the NCAA-DOD Concussion Consortium

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S22.2-S23
Author(s):  
Brett Gunn ◽  
Michael McCrea ◽  
Steven Broglio ◽  
R. Davis Moore
Keyword(s):  
Repeated Measures ◽  
Stimulant Medication ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Adhd Group ◽  
Post Injury ◽  
Stimulant Medications ◽  
Multiple Variables ◽  
Concussion Recovery ◽  
The Impact

ObjectiveWe sought to longitudinally evaluate concussion recovery in collegiate athletes with ADHD who were and were not taking psycho-stimulant medication.BackgroundPsycho-stimulant medication is commonly prescribed to individuals with ADHD. Some have posited that psycho-stimulant medications may mitigate impairments following sport-related concussion. However, no studies longitudinally evaluated the influence of psycho-stimulant medications on concussion recovery in collegiate athletes.Design/MethodsData from the NCAA-DOD Grand Alliance: Concussion Assessment, Research, and Education (CARE) Consortium were used to evaluate athletes with ADHD who were not taking psycho-stimulant medications (Rx-ADHD; n = 20), athletes with ADHD who were taking psycho-stimulant medications (Rx+ADHD; n = 20), and controls (n = 80). Athletes with ADHD were double-matched to controls on biological sex, age, and body mass index. All athletes were assessed prior to their sporting season, 24-48 hours post-injury, and again upon unrestricted return-to-play (RTP). Cognition and clinical symptoms were evaluated using the ImPACT test.ResultsAthletes in the Rx-ADHD (10.4 ± 1.5 days) and Rx + ADHD (11.9 ± 1.7) groups exhibited prolonged symptom durations compared to controls (4.2 ± .8; p’s ≤ 0.05). Repeated-measures analyses of covariance (baseline scores = covariate) group × time interactions for multiple variables (p’s ≤ 0.05). Univariate analyses revealed that both groups with ADHD demonstrated poorer verbal memory, and greater total symptoms at 24–48 hours post-injury than controls (p’s ≤ 0.01). Additionally, athletes in the Rx-ADHD group demonstrated poorer cognitive efficiency at 24–48 hours post-injury, and at RTP than controls (p’s ≤ 0.05). Lastly, athletes in the Rx+ADHD group demonstrated slower visual motor speed at 24–48 hours post-injury, and at RTP than controls (p’s ≤ 0.05).ConclusionsT Our findings suggest that following concussion athletes with ADHD may experience longer recovery than controls, regardless of medicated status. Interestingly, athletes with ADHD who were taking medication did not appear to have different recovery time relative to un-medicated athletes with ADHD.

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