Baseline Evaluation of Concussion-Like Symptoms and Modifying Factors in Collegiate Club-Sport Athletes

Abstract

Context Collegiate club-sport athletes participate in a variety of competitive sports and have been understudied in the concussion literature. Baseline performance measures are warranted to better understand assessment and management. Objective To quantify normative values and modifying factor effects of sex, concussion history, diagnosed attention disabilities (ADHD), and sport-type on baseline symptom evaluation among collegiate club-sport athletes. Design Cross-sectional study. Setting Retrospective chart review Patients or Other Participants 1034 collegiate club-sport athletes (N=649 male, 62.7%) from 29 different sports at a single institution. Main Outcome Measures Chart reviews were completed for club-sport athletes who completed athlete background and symptom evaluation on the Sport Concussion Assessment Tool – 5th edition (SCAT5) as baseline concussion assessment during a single academic year. Demographics (e.g., age, sex, sport), background medical information (e.g., concussion history, ADHD, etc.) and symptom evaluation, consisting of individual 22-item symptom reporting, total number of symptoms (TS), symptom severity (SS) scores, and symptom-factors (e.g., physical, cognitive, insomnia, and emotional) were analyzed. Results 68% of club-sport athletes were asymptomatic on baseline symptom reporting, with 3–12% reporting mild symptoms and ≤4% reporting moderate and severe symptoms. Modifier groups differed with higher TS and SS in females (p<.001), individuals reporting a history of concussion (p<.001), and those with ADHD (TS p=.04, SS p =.02). Similar significant findings were noted for females and the history of concussion group on all 4 symptom-factors, however collision/contact sports also reported greater cognitive (p=.03) and insomnia (p=.02) factors. Those with ADHD reported higher cognitive (p<.001) factors. Conclusions Normative symptoms were produced for a collegiate club-sport sample, revealing ~70% asymptomatic reporting. Higher TS and SS scores were reported by females and those with a history of concussion. Cognitive-specific symptoms were greater in those diagnosed with ADHD and who participated in collision/contact sports.