Female athletes who sustained concussions performed worse than male athletes and reported more symptoms, according to new research from Michigan State University. The study results warrant consideration from clinicians when treating concussions, according to researchers.
Certified athletic trainer Tracey Covassin, PhD, and colleagues examined the age and sex differences in concussion outcomes in a 2-year cohort study that included 296 participants (203 male and 93 female high school and college athletes) aged 14 to 25 years from multiple states who sustained concussions during the 2008-2009 and 2009-2010 academic years. Nearly 2,000 athletes were tested at baseline to obtain the concussion sample, according to the researchers.
A concussion was defined in the study as “a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces,” and met the following criteria:
- Presence of on-field signs (posttraumatic amnesia, loss of consciousness) and symptoms (dizziness, headache) as determined by a sports medicine professional.
- Decrease from baseline levels in at least one post-concussion neurocognitive score determined by reliable change estimates.
- Increase from baseline levels in post-concussion symptoms determined by reliable change estimates.
Before sustaining concussions, the participants — who played a number of different sports, including football, soccer, volleyball, basketball and ice hockey — completed the online version of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), a neurocognitive battery that tests memory, visual memory, visual processing speed and reaction time. They also completed the Post-Concussion Symptom Scale (PCSS) at baseline. The ImPACT battery was administered again at 2, 7 and 14 days after sustaining a concussion, and a personal trainer assessed participants’ static and dynamic postural stability using the Balance Error Scoring System (BESS) at 1, 2 and 3 days post-concussion.
Data were analyzed using descriptive and inferential statistics, the researchers wrote.
Results showed that female athletes performed worse than male athletes on visual memory (65.1% vs. 70.1%) and reported more symptoms (14.4 vs. 10.1). High school athletes performed worse than college athletes on verbal (78.8% and 82.7%) and visual memory assessments (65.8% vs. 69.4%), and high school athletes continued to have verbal memory impairment 7 days after sustaining concussions, compared with college athletes, according to researchers. High school male athletes scored worse than college male athletes on the BESS (18.8 vs. 13). However, college females scored worse than high school female athletes on the BESS (21.1 vs. 16.9).
Most concussions occurred playing football (n=121), according to researchers, followed by women’s soccer (n=30).
“The results of the current study suggest that age and sex should be considered when interpreting the results of symptom reports, [neurocognitive testing], and postural instability assessments following concussion,” the researchers wrote.
Disclosure: The National Operating Committee on Standards for Athletic Equipment funded this study.