Sex Differences in Recovery Trajectories of Assessments for Sport-Related Concussion Among NCAA Athletes: A CARE Consortium Study.
Journal
Sports medicine (Auckland, N.Z.)
ISSN: 1179-2035
Titre abrégé: Sports Med
Pays: New Zealand
ID NLM: 8412297
Informations de publication
Date de publication:
22 Dec 2023
22 Dec 2023
Historique:
accepted:
06
12
2023
medline:
22
12
2023
pubmed:
22
12
2023
entrez:
22
12
2023
Statut:
aheadofprint
Résumé
The purpose of this study was to determine sex differences in recovery trajectories of assessments for sport-related concussion using Concussion Assessment, Research and Education (CARE) Consortium data. National Collegiate Athletic Association athletes (N = 906; 61% female) from sex-comparable sports completed a pre-season baseline assessment and post-sport-related concussion assessments within 6 h of injury, 24-48 h, when they initiated their return to play progression, when they were cleared for unrestricted return to play, and 6 months post-injury. Assessments included the Standardized Assessment of Concussion, Balance Error Scoring System, Brief Symptom Inventory-18, Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), Sport Concussion Assessment Tool-3 symptom evaluation, Clinical Reaction Time, King-Devick test, Vestibular Ocular Motor Screen, 12-item Short-Form Health Survey, Hospital Anxiety and Depression Scale, and Satisfaction with Life Scale. Only the Vestibular Ocular Motor Screen Total Symptom Score at the 24-48 h timepoint (p = 0.005) was statistically significantly different between sexes. Specifically, female athletes (mean = 60.2, 95% confidence interval [CI] 51.5-70.4) had higher Vestibular Ocular Motor Screen Total Symptom Scores than male athletes (mean = 36.9, 95% CI 27.6-49.3), but this difference resolved by the time of return-to-play initiation (female athletes, mean = 1.8, 95% CI 1.1-2.9; male athletes, mean = 4.1, 95% CI 1.5-10.9). Sport-related concussion recovery trajectories for most assessments were similar for female and male National Collegiate Athletic Association athletes except for Vestibular Ocular Motor Screen symptoms within 48 h of sport-related concussion, which was greater in female athletes. Female athletes had a greater symptom burden across all timepoints, suggesting that cross-sectional observations may indicate sex differences despite similar recovery trajectories.
Identifiants
pubmed: 38133787
doi: 10.1007/s40279-023-01982-2
pii: 10.1007/s40279-023-01982-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
April Hoy
(A)
Justus D Ortega
(JD)
Nicholas Port
(N)
Patrick G O'Donnell
(PG)
Christopher D'Lauro
(C)
Kenneth L Cameron
(KL)
Joshua T Goldman
(JT)
Holly J Benjamin
(HJ)
Thomas W Kaminski
(TW)
Julianne Schmidt
(J)
Michael Collins
(M)
Jeffrey J Bazarian
(JJ)
Stefan Duma
(S)
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
Pierpoint LA, Collins C. Epidemiology of sport-related concussion. Clin Sports Med. 2021;40:1–18.
pubmed: 33187601
doi: 10.1016/j.csm.2020.08.013
Lin CY, Casey E, Herman DC, et al. Sex differences in common sports injuries. PM R. 2018;10:1073–82.
pubmed: 29550413
pmcid: 6138566
doi: 10.1016/j.pmrj.2018.03.008
Cheng J, Ammerman B, Santiago K, et al. Sex-based differences in the incidence of sports-related concussion: systematic review and meta-analysis. Sports Health. 2019;11:486–91.
pubmed: 31567052
pmcid: 6822209
doi: 10.1177/1941738119877186
Master CL, Katz BP, Arbogast KB, et al. 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. Br J Sports Med. 2021;55:1387–94.
pubmed: 33355211
doi: 10.1136/bjsports-2020-103316
Henry LC, Elbin RJ, Collins MW, et al. Examining recovery trajectories after sport-related concussion with a multimodal clinical assessment approach. Neurosurgery. 2016;78:232–41.
pubmed: 26445375
doi: 10.1227/NEU.0000000000001041
Baker JG, Leddy JJ, Darling SR, et al. Gender differences in recovery from sports-related concussion in adolescents. Clin Pediatr. 2016;55:771–5.
doi: 10.1177/0009922815606417
Covassin T, Elbin RJ, Bleecker A, et al. Are there differences in neurocognitive function and symptoms between male and female soccer players after concussions? Am J Sports Med. 2013;41:2890–5.
pubmed: 24197616
doi: 10.1177/0363546513509962
Covassin T, Swanik CB, Sachs ML. Epidemiological considerations of concussions among intercollegiate athletes. Appl Neuropsychol. 2003;10:12–22.
pubmed: 12734071
doi: 10.1207/S15324826AN1001_3
Kerr ZY, Zuckerman SL, Wasserman EB, et al. Factors associated with post-concussion syndrome in high school student-athletes. J Sci Med Sport. 2018;21:447–52.
pubmed: 28939003
doi: 10.1016/j.jsams.2017.08.025
Black AM, Sergio LE, Macpherson AK. The epidemiology of concussions: number and nature of concussions and time to recovery among female and male Canadian varsity athletes 2008 to 2011. Clin J Sport Med. 2017;27:52–6.
pubmed: 26862834
doi: 10.1097/JSM.0000000000000308
Mihalik JP, Ondrak KS, Guskiewicz KM, et al. The effects of menstrual cycle phase on clinical measures of concussion in healthy college-aged females. J Sci Med Sport. 2009;12:383–7.
pubmed: 18771954
doi: 10.1016/j.jsams.2008.05.003
Snook ML, Henry LC, Sanfilippo JS, et al. Association of concussion with abnormal menstrual patterns in adolescent and young women. JAMA Pediatr. 2017;171:879–86.
pubmed: 28672284
pmcid: 5710410
doi: 10.1001/jamapediatrics.2017.1140
Wallace J, Covassin T, Beidler E. Sex differences in high school athletes’ knowledge of sport-related concussion symptoms and reporting behaviors. J Athl Train. 2017;52:682–8.
pubmed: 28561626
pmcid: 5517124
doi: 10.4085/1062-6050-52.3.06
Brown DA, Elsass JA, Miller AJ, et al. Differences in symptom reporting between males and females at baseline and after a sports-related concussion: a systematic review and meta-analysis. Sports Med. 2015;45:1027–40.
pubmed: 25971368
doi: 10.1007/s40279-015-0335-6
Caccese JB, Buckley TA, Tierney RT, et al. Head and neck size and neck strength predict linear and rotational acceleration during purposeful soccer heading. Sports Biomech. 2018;17:462–76.
pubmed: 29037111
Putukian M, Riegler K, Amalfe S, et al. Preinjury and postinjury factors that predict sports-related concussion and clinical recovery time. Clin J Sport Med. 2021;31:15–22.
pubmed: 30540572
doi: 10.1097/JSM.0000000000000705
McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport: the 5th International Conference on Concussion in Sport held in Berlin, October 2016. Br J Sports Med. 2017;51:838–47.
Broglio SP, Cantu RC, Gioia GA, et al. National Athletic Trainers’ Association position statement: management of sport concussion. J Athl Train. 2014;49:245–65.
pubmed: 24601910
pmcid: 3975780
doi: 10.4085/1062-6050-49.1.07
Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 2019;53:213–25.
pubmed: 30705232
doi: 10.1136/bjsports-2018-100338
D’Lauro C, Jones ER, Swope LM, et al. Under-representation of female athletes in research informing influential concussion consensus and position statements: an evidence review and synthesis. Br J Sports Med. 2022;56:981–7.
doi: 10.1136/bjsports-2021-105045
Broglio SP, McCrea M, McAllister T, et al. A national study on the effects of concussion in collegiate athletes and US Military Service Academy members: the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium structure and methods. Sports Med. 2017;47:1437–51.
pubmed: 28281095
pmcid: 5488134
doi: 10.1007/s40279-017-0707-1
Putukian M, D’Alonzo BA, Campbell-McGovern CS, et al. The Ivy League-Big Ten Epidemiology of Concussion Study: a report on methods and first findings. Am J Sports Med. 2019;47:1236–47.
pubmed: 30943078
doi: 10.1177/0363546519830100
Carney N, Ghajar J, Jagoda A, et al. Concussion guidelines step 1: systematic review of prevalent indicators. Neurosurgery. 2014;75:S3-15.
pubmed: 25006974
doi: 10.1227/NEU.0000000000000433
McCrea M. Standardized mental status assessment of sports concussion. Clin J Sport Med. 2001;11:176–81.
pubmed: 11495322
doi: 10.1097/00042752-200107000-00008
Finnoff JT, Peterson VJ, Hollman JH, et al. Intrarater and interrater reliability of the Balance Error Scoring System (BESS). PM R. 2009;1:50–4.
pubmed: 19627872
doi: 10.1016/j.pmrj.2008.06.002
Caccese JB, Iverson GL, Hunzinger KJ, et al. Factors associated with symptom reporting in US Service Academy cadets and NCAA student athletes without concussion: findings from the CARE Consortium. Sports Med. 2021;51:1087–105.
pubmed: 33428120
doi: 10.1007/s40279-020-01415-4
Meachen S, Hanks RA, Millis SR, et al. The reliability and validity of the brief symptom inventory-18 in persons with traumatic brain injury. Arch Phys Med Rehabil. 2008;89:958–65.
pubmed: 18452746
doi: 10.1016/j.apmr.2007.12.028
Houck ZM, Asken BM, Bauer RM, et al. Multivariate base rates of low scores and reliable decline on ImPACT in healthy collegiate athletes using Care Consortium norms. J Int Neuropsychol Soc. 2019;25:961–71.
pubmed: 31272517
doi: 10.1017/S1355617719000729
Caccese JB, Eckner JT, Franco-MacKendrick L, et al. Clinical reaction-time performance factors in healthy collegiate athletes. J Athl Train. 2020;55:601–7.
pubmed: 32320283
pmcid: 7319734
doi: 10.4085/1062-6050-164-19
Caccese JB, Eckner JT, Franco-MacKendrick L, et al. Interpreting clinical reaction time change and recovery after concussion: a baseline versus norm-based cutoff score comparison. J Athl Train. 2021;56(8):851–9.
pubmed: 34375406
pmcid: 8359707
doi: 10.4085/1062-6050-457-20
Chrisman S, Harmon KG, Schmidt JD, et al. Impact of factors that affect reading skill level on King–Devick baseline performance time. Ann Biomed Eng. 2019;47:2122–7.
pubmed: 30341738
doi: 10.1007/s10439-018-02150-8
Clugston JR, Houck ZM, Asken BM, et al. Relationship between the King–Devick test and commonly used concussion tests at baseline. J Athl Train. 2019;54:1247–53.
pubmed: 31584854
pmcid: 6922559
doi: 10.4085/1062-6050-455-18
Ferris LM, Kontos AP, Eagle SR, et al. Utility of VOMS, SCAT3, and ImPACT baseline evaluations for acute concussion identification in collegiate athletes: findings from the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium. Am J Sports Med. 2022;50:1106–19.
pubmed: 35179972
doi: 10.1177/03635465211072261
Ware JE Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.
pubmed: 8628042
doi: 10.1097/00005650-199603000-00003
Sigurdardottir S, Andelic N, Roe C, et al. Post-concussion symptoms after traumatic brain injury at 3 and 12 months post-injury: a prospective study. Brain Inj. 2009;23:489–97.
pubmed: 19484622
doi: 10.1080/02699050902926309
Pavot W, Diener ED, Colvin CR, et al. Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures. J Pers Assess. 1991;57:149–61.
pubmed: 1920028
doi: 10.1207/s15327752jpa5701_17
Bretzin AC, Esopenko C, D’Alonzo BA, et al. Clinical recovery timelines after sport-related concussion in men’s and women’s collegiate sports. J Athl Train. 2022;57:678–87.
pubmed: 33626145
doi: 10.4085/601-20
D’Alonzo BA, Bretzin AC, Wiebe DJ. The role of reported affective symptoms and anxiety in recovery trajectories after sport-related concussion. Am J Sports Med. 2022;50:2258–70.
pubmed: 35647797
doi: 10.1177/03635465221098112
Broshek DK, Kaushik T, Freeman JR, et al. Sex differences in outcome following sports-related concussion. J Neurosurg. 2005;102:856–63.
pubmed: 15926710
doi: 10.3171/jns.2005.102.5.0856
Schneider KJ, Emery CA, Kang J, et al. Examining Sport Concussion Assessment Tool ratings for male and female youth hockey players with and without a history of concussion. Br J Sports Med. 2010;44:1112–7.
pubmed: 20966034
doi: 10.1136/bjsm.2009.071266
Covassin T, Savage JL, Bretzin AC, et al. Sex differences in sport-related concussion long-term outcomes. Int J Psychophysiol. 2018;132:9–13.
pubmed: 28927725
doi: 10.1016/j.ijpsycho.2017.09.010
Covassin T, Elbin RJ, Harris W, et al. The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion. Am J Sports Med. 2012;40:1303–12.
pubmed: 22539534
doi: 10.1177/0363546512444554
Chiang Colvin A, Mullen J, Lovell MR, et al. The role of concussion history and gender in recovery from soccer-related concussion. Am J Sports Med. 2009;37:1699–704.
doi: 10.1177/0363546509332497
Zuckerman SL, Solomon GS, Forbes JA, et al. Response to acute concussive injury in soccer players: is gender a modifying factor? J Neurosurg Pediatr. 2012;10:504–10.
pubmed: 23030348
doi: 10.3171/2012.8.PEDS12139
Sufrinko AM, Mucha A, Covassin T, et al. Sex differences in vestibular/ocular and neurocognitive outcomes following sport-related concussion. Clin J Sport Med. 2017;27:133.
pubmed: 27379660
pmcid: 5203982
doi: 10.1097/JSM.0000000000000324
Pearce KL, Sufrinko A, Lau BC, et al. Near point of convergence after a sport-related concussion: measurement reliability and relationship to neurocognitive impairment and symptoms. Am J Sports Med. 2015;43:3055–61.
pubmed: 26453625
pmcid: 5067104
doi: 10.1177/0363546515606430
Patricios JS, Davis GA, Ahmed OH, et al. Introducing the sport concussion office assessment tool 6 (SCOAT6). Br J Sports Med. 2023;57(11):648–50.
pubmed: 37316211
doi: 10.1136/bjsports-2023-106860
Covassin T, Elbin RJ III, Larson E, et al. Sex and age differences in depression and baseline sport-related concussion neurocognitive performance and symptoms. Clin J Sport Med. 2012;22:98–104.
pubmed: 22246342
doi: 10.1097/JSM.0b013e31823403d2
Cottle JE, Hall EE, Patel K, et al. Concussion baseline testing: preexisting factors, symptoms, and neurocognitive performance. J Athl Train. 2017;52:77–81.
pubmed: 28071936
pmcid: 5343531
doi: 10.4085/1062-6050-51.12.21
Covassin T, Swanik CB, Sachs M, et al. Sex differences in baseline neuropsychological function and concussion symptoms of collegiate athletes. Br J Sports Med. 2006;40:923–7.
pubmed: 16990442
pmcid: 2465022
doi: 10.1136/bjsm.2006.029496
Lewis RS, Kamptner NL. Sex differences in spatial task performance of patients with and without unilateral cerebral lesions. Brain Cogn. 1987;6:142–52.
pubmed: 3593554
doi: 10.1016/0278-2626(87)90115-1
Beatty WW, Mold JW, Gontkovsky ST. RBANS performance: influences of sex and education. J Clin Exp Neuropsychol. 2003;25:1065–9.
pubmed: 14566580
doi: 10.1076/jcen.25.8.1065.16732