First-Time Sports-Related Concussion Recovery: The Role of Sex, Age, and Sport

Neidecker, John; Gealt, David B.; Luksch, John; Weaver, Martin D.

doi:10.7556/jaoa.2017.120

Cited by 23 publications

(13 citation statements)

References 31 publications

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“…is study also reported that 75% of male athletes showed full recovery from their concussion by 3 weeks compared with 42% of females [13].…”

Section: Introductionmentioning

confidence: 71%

“…Females were found to be 2 times more likely than males to report severe noise sensitivity following a concussion [12]. Males, on the contrary, show a higher incidence of anterograde amnesia and loss of consciousness than females [13].…”

Section: Introductionmentioning

confidence: 94%

“…e duration of symptoms shows sex differences with a median of 11 days for males to recover compared with the 28 days for females [13].…”

Section: Introductionmentioning

confidence: 99%

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Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Lariviere

Bureau

Marshall³

et al. 2019

Journal of Sports Medicine

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Concussions are among the most common neurological conditions, with emergency departments and sports injury clinics seeing hundreds of patients each year. The consideration of risk factors such as age, sex, and comorbid conditions are very important when looking at individual physiological and psychological outcomes after a concussion. The purpose of this study was to look at four comorbid conditions (depression, anxiety, behavioural disorder, or learning disability) and identify any interactions with age and sex in symptom presentation after suffering a concussion. A total of 4,865 participants from the CCMI (Complete Concussion Management Inc.) dataset were used with 1,577 self-identified with a diagnosis of anxiety, depression, a behavioural disorder, or a learning disability. Fixed-factor analyses of variance were used with age and sex as fixed, grouping factors and symptom total and severity as dependent measures. For the individuals who did not have one of the 4 mental health conditions (3,288 control participants), symptom total and symptom severity increased with age (p<0.05), and females showed more symptoms and a higher symptom severity than males across all ages (p<0.05). A diagnosis of anxiety or depression exacerbated total symptoms and symptom severity from 25–50% above control levels in the 19 and under age groups, while depression or anxiety exacerbated total symptoms and severity by 10–15% in males more than females over 20. A diagnosis of a behavioural disorder or a learning disability exacerbated symptom severity by approximately 50% above control levels in 13–19–year-old females and in males of 30 years and older. This study highlights how the presence of a mental health condition may alter concussion symptom presentation dependent on age and sex. The identification of risk factors and how they may interact can be of great value to health care providers who manage concussion symptoms and recovery.

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“…is study also reported that 75% of male athletes showed full recovery from their concussion by 3 weeks compared with 42% of females [13].…”

Section: Introductionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Lariviere

Bureau

Marshall³

et al. 2019

Journal of Sports Medicine

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“…Epidemiological studies have demonstrated higher rates of SRC in female university athletes compared to their male counterparts when competing in comparable sports 13,15,17,49 . Relative to males, females also experience more severe symptoms and longer recovery patterns post-SRC 12,48 . Sex differences in cervical spine biomechanics are one hypothesis put forth regarding differences in SRC rates and clinical outcomes post-SRC in males and females 12,14,66 .…”

Section: Introductionmentioning

confidence: 95%

The Potential Role of the Cervical Spine in Sports-Related Concussion: Clinical Perspectives and Considerations for Risk Reduction

Streifer¹,

Brown²,

Porfido³

et al. 2019

Journal of Orthopaedic & Sports Physical Therapy

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Sports-related concussions (SRC) occur due to biomechanical forces to the head or neck that can result in pathophysiological changes in the brain. The musculature of the cervical spine has been identified as one potential factor in reducing SRC risk as well as underlying sex differences in SRC rates. Recent research has demonstrated that linear and rotational head acceleration, as well as the magnitude of force, upon impact is influenced by cervical spine biomechanics. Increased neck strength and girth is associated with reduced linear and rotational head acceleration during impact. Past work has also shown that overall neck strength and girth are lower in athletes with SRC. Additionally, differences in cervical spine biomechanics are hypothesized as a critical factor underlying sex differences in SRC rates. Specifically, compared to males, females tend to have less neck strength and girth which is associated with increased linear and rotational head acceleration. Although our ability to detect SRC has greatly improved, our ability to prevent SRCs from occurring and decrease the severity of clinical outcomes post-injury is limited. However, we suggest, along with others, that cervical spine biomechanics is a modifiable factor in reducing SRC risk. We review the role of the cervical spine in reducing SRC risk, and how this differs dependent on sex. We discuss clinical considerations for the examination of the cervical spine and the potential clinical relevance for SRC prevention. Additionally, we provide suggestions for future research examining cervical spine properties as modifiable factors in reducing SRC risk.

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“…4,5 Furthermore, female athletes have a higher concussion symptom burden, longer symptom duration, and worse vestibular ocular deficits. 11,32,46 Despite a higher concussion rate and symptom burden among female athletes, efforts to understand the frequency of head impacts to reduce exposure have rarely included female athletes: a systematic review of head impact kinematic studies revealed that only 1 in 5 included female athletes, 34 and direct male to female comparisons are rare in studies of ice hockey, soccer, and lacrosse. 29,41,52 As a result, we have limited knowledge of head impact exposure differences between genders for similar sports.…”

mentioning

confidence: 99%

Sport- and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports

Huber

Patton

McDonald

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Repeated head impacts sustained by athletes have been linked to short-term neurophysiologic deficits; thus, there is growing concern about the number of head impacts sustained in sports. Accurate head impact exposure data obtained via head impact sensors may help identify appropriate strategies across sports and between genders to mitigate repetitive head impacts. Purpose: To quantify sport- and gender-based differences in head impact rate and mechanism for adolescents. Study Design: Cohort study; Level of evidence, 2. Methods: High school female and male varsity soccer, basketball, lacrosse, and field hockey (female only) teams were instrumented with headband-mounted impact sensors during games over 2 seasons of soccer and 1 season of basketball, lacrosse, and field hockey. Video review was used to remove false-positive sensor-recorded events, and the head impact rate per athlete-exposure (AE) was calculated. Impact mechanism was categorized as equipment to head, fall, player to head, or head to ball (soccer only). Results: Male players had significantly higher head impact rates as compared with female players in soccer (3.08 vs 1.41 impacts/AE; rate ratio, 2.2 [95% CI, 1.8-2.6]), basketball (0.90 vs 0.25; 3.6 [2.6-4.6]), and lacrosse (0.83 vs 0.06; 12.9 [10.1-15.8]). Impact mechanism distributions were similar within sports between boys and girls. In soccer, head to ball represented 78% of impacts, whereas at least 88% in basketball were player-to-player contact. Conclusion: Across sports for boys and girls, soccer had the highest impact rate. Male high school soccer, basketball, and lacrosse teams had significantly higher head impact rates than did female teams of the same sport. For girls, basketball had a higher head impact rate than did lacrosse and field hockey, and for boys, basketball had a similar impact rate to lacrosse, a collision sport. Sport differences in the distribution of impact mechanisms create sport-specific targets for reducing head impact exposure.

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First-Time Sports-Related Concussion Recovery: The Role of Sex, Age, and Sport

Abstract: Female athletes aged 11 to 18 years with first-time, sports-related concussions remained symptomatic for a longer period when compared with male athletes of similar age, regardless of sport played. The mechanism behind this difference needs to be further elucidated.

Cited by 23 publications

References 31 publications

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

Interaction between Age, Sex, and Mental Health Status as Precipitating Factors for Symptom Presentation in Concussed Individuals

The Potential Role of the Cervical Spine in Sports-Related Concussion: Clinical Perspectives and Considerations for Risk Reduction

Sport- and Gender-Based Differences in Head Impact Exposure and Mechanism in High School Sports

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