TY - JOUR
T1 - Female Collegiate Athletes’ Concussion Characteristics and Recovery Patterns
T2 - A Report from the NCAA-DoD CARE Consortium
AU - Lempke, Landon B.
AU - Caccese, Jaclyn B.
AU - Syrydiuk, Reid A.
AU - Buckley, Thomas A.
AU - Chrisman, Sara P.D.
AU - Clugston, James R.
AU - Eckner, James T.
AU - Ermer, Elsa
AU - Esopenko, Carrie
AU - Jain, Divya
AU - Kelly, Louise A.
AU - Memmini, Allyssa K.
AU - Mozel, Anne E.
AU - Putukian, Margot
AU - Susmarski, Adam
AU - Pasquina, Paul F.
AU - McCrea, Michael A.
AU - McAllister, Thomas W.
AU - Broglio, Steven P.
AU - Master, Christina L.
N1 - Funding Information:
This study was made possible, in part, with support from the Grand Alliance Concussion Assessment, Research, and Education Consortium, funded by the National Collegiate Athletic Association and the Department of Defense. The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702-5014, USA is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH-14-2-0151. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (Defense Health Program funds).
Funding Information:
All disclosures below are not directly related to the current project, but are reported for full transparency to readers. Dr. Landon Lempke has current or prior funding unrelated to the current project from the National Athletic Trainers’ Association (NATA), American College of Sports Medicine (ACSM), Eastern Athletic Trainers’ Association, VALD, internally from university affiliations, and has received various speaker honorarium and travel reimbursement for talks given. Dr. Thomas Buckley reports current or prior funding from NIH, Henry F. Jackson Foundation for the Advancement of Military Medicine, and State Space, Inc. Dr. James Clugston reports current or prior funding from the NFL, and a stipend for serving on an institutional Data Safety Monitoring Board. Dr. James Eckner reports current or prior funding from NIH, NSF, and internal university funding. Dr. Eckner also reports being a co-author (stipend received) for a book chapter in “Concussion Management for Wheelchair Athletes”, on the editorial board (unpaid) for the journal Physical Medicine and Rehabilitation, and a co-inventor on US Patent #8657295, and a Data and Safety Monitoring Board Member for an unrelated NIH Project. Dr. Margot Putukian reports the following committee and position roles: CMO for MLS, Senior Advisor NFL HN&S Committee, FA Research Task Force, CISG Expert Group, NOCSAE SAC. Dr. Putukian also receives royalties from Netters Sports Medicine textbook, and UpToDate chapter. Dr. Michael McCrea has received research funding from the NIH, CDC, DoD, NCAA, NFL, and Abbott Laboratories. Dr. Thomas McAllister reports current or prior grant support from NIH, DoD, and NCAA, as well as textbook royalties from the “Textbook of Traumatic Brain Injury” from the American Psychiatric Association Publishing, Inc., and is an unpaid member for the concussion Scientific Advisory Committee for the Australian-Rules Football Conference. Dr. Steven Broglio has current or past research funding from the NIH, CDC, DoD, NCAA, NATA, NFL/Under Armour/GE; Simbex; and ElmindA. Dr. Broglio has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SHRed Concussions external advisory board (unpaid), medico-legal litigation, and received speaker honorarium and travel reimbursements for talks given. Dr. Broglio is also a co-author of “Biomechanics of Injury (3rd edition)” and has a patent pending on “Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source” (U.S. Application No. 17/164490). Lastly, Dr. Broglio is on the and is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training and Sports Health Care (2008 to present), and British Journal of Sports Medicine (2008 to 2019).
Publisher Copyright:
© 2023, The Author(s) under exclusive licence to Biomedical Engineering Society.
PY - 2023
Y1 - 2023
N2 - Concussion has been described in the United States (US) collegiate student–athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student–athletes’ initial injury characteristics and return to activity outcomes following concussion. Female collegiate student–athletes (n = 1393) from 30-US institutions experienced a concussion and completed standardized, multimodal concussion assessments from pre-injury through unrestricted return to play (uRTP) in this prospective, longitudinal cohort study. Initial injury presentation characteristics, assessment, and return to activity outcomes [<48-h (acute), return to learn, initiate return to play (iRTP), uRTP] were collected. We used descriptive statistics to report injury characteristics, return to activity outcomes, and post-injury assessment performance change categorization (worsened, unchanged, improved) based on change score confidence rank criteria across sport contact classifications [contact (n = 661), limited (n = 446), non-contact (n = 286)]. The median (25th to 75th percentile) days to return to learn was 6.0 (3.0–10.0), iRTP was 8.1 (4.8–13.8), and uRTP was 14.8 (9.9–24.0), but varied by contact classification. Across contact levels, the majority experienced worse SCAT total symptom severity (72.8–82.6%), ImPACT reaction time (91.2–92.6%), and BSI-18 total score (45.2–51.8%) acutely relative to baseline, but unchanged BESS total errors (58.0–60.9%), SAC total score (71.5–76.1%), and remaining ImPACT domains (50.6–66.5%). Our findings provide robust estimates of the typical female collegiate student–athlete presentation and recovery trajectory following concussion, with overall similar findings to the limited female collegiate student–athlete literature. Overall varying confidence rank classification was observed acutely. Our findings provide clinically-relevant insights for athletes, clinicians, researchers, and policymakers to inform efforts specific to females experiencing concussion.
AB - Concussion has been described in the United States (US) collegiate student–athlete population, but female-specific findings are often underrepresented and underreported. Our study aimed to describe female collegiate student–athletes’ initial injury characteristics and return to activity outcomes following concussion. Female collegiate student–athletes (n = 1393) from 30-US institutions experienced a concussion and completed standardized, multimodal concussion assessments from pre-injury through unrestricted return to play (uRTP) in this prospective, longitudinal cohort study. Initial injury presentation characteristics, assessment, and return to activity outcomes [<48-h (acute), return to learn, initiate return to play (iRTP), uRTP] were collected. We used descriptive statistics to report injury characteristics, return to activity outcomes, and post-injury assessment performance change categorization (worsened, unchanged, improved) based on change score confidence rank criteria across sport contact classifications [contact (n = 661), limited (n = 446), non-contact (n = 286)]. The median (25th to 75th percentile) days to return to learn was 6.0 (3.0–10.0), iRTP was 8.1 (4.8–13.8), and uRTP was 14.8 (9.9–24.0), but varied by contact classification. Across contact levels, the majority experienced worse SCAT total symptom severity (72.8–82.6%), ImPACT reaction time (91.2–92.6%), and BSI-18 total score (45.2–51.8%) acutely relative to baseline, but unchanged BESS total errors (58.0–60.9%), SAC total score (71.5–76.1%), and remaining ImPACT domains (50.6–66.5%). Our findings provide robust estimates of the typical female collegiate student–athlete presentation and recovery trajectory following concussion, with overall similar findings to the limited female collegiate student–athlete literature. Overall varying confidence rank classification was observed acutely. Our findings provide clinically-relevant insights for athletes, clinicians, researchers, and policymakers to inform efforts specific to females experiencing concussion.
KW - Gender
KW - Mild traumatic brain injury
KW - Neurocognitive
KW - Postural stability
KW - Psychological
UR - http://www.scopus.com/inward/record.url?scp=85172134125&partnerID=8YFLogxK
U2 - 10.1007/s10439-023-03367-y
DO - 10.1007/s10439-023-03367-y
M3 - Article
C2 - 37751028
AN - SCOPUS:85172134125
SN - 0090-6964
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
ER -