Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium

doi:10.1007/s10439-023-03367-y

. 2024 Oct;52(10):2741-2755.

doi: 10.1007/s10439-023-03367-y. Epub 2023 Sep 26.

Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium

Landon B Lempke^{1

2

3}, Jaclyn B Caccese⁴, Reid A Syrydiuk⁵, Thomas A Buckley⁶, Sara P D Chrisman⁷, James R Clugston⁸, James T Eckner⁹, Elsa Ermer^{10

11}, Carrie Esopenko¹², Divya Jain¹², Louise A Kelly¹³, Allyssa K Memmini¹⁴, Anne E Mozel¹⁵, Margot Putukian¹⁶, Adam Susmarski¹⁷, Paul F Pasquina¹¹, Michael A McCrea¹⁸, Thomas W McAllister¹⁹, Steven P Broglio⁵, Christina L Master^{15

20}; CARE Consortium Investigators

Affiliations

¹ Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA. llempke@umich.edu.
² Exercise and Sport Science Initiative, University of Michigan, Ann Arbor, MI, USA. llempke@umich.edu.
³ , 830 North University Avenue, Suite 4000, Ann Arbor, MI, 48109, USA. llempke@umich.edu.
⁴ School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
⁵ Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
⁶ Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
⁷ Division of Adolescent Medicine, University of Washington, Seattle, WA, USA.
⁸ Departments of Community Health Family Medicine and Neurology, University of Florida, Gainesville, FL, USA.
⁹ Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
¹⁰ Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
¹¹ Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
¹² Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹³ Department of Exercise Science, California Lutheran University, Thousand Oaks, CA, USA.
¹⁴ Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, NM, USA.
¹⁵ Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹⁶ Major League Soccer, Princeton, NJ, USA.
¹⁷ Department of Orthopedics and Sports Medicine, United States Naval Academy, Annapolis, MD, USA.
¹⁸ Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁹ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
²⁰ Orthopaedics and Sports Medicine, Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

PMID: 37751028
DOI: 10.1007/s10439-023-03367-y

Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium

Landon B Lempke et al. Ann Biomed Eng. 2024 Oct.

. 2024 Oct;52(10):2741-2755.

doi: 10.1007/s10439-023-03367-y. Epub 2023 Sep 26.

Authors

Affiliations

¹ Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA. llempke@umich.edu.
² Exercise and Sport Science Initiative, University of Michigan, Ann Arbor, MI, USA. llempke@umich.edu.
³ , 830 North University Avenue, Suite 4000, Ann Arbor, MI, 48109, USA. llempke@umich.edu.
⁴ School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.
⁵ Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.
⁶ Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
⁷ Division of Adolescent Medicine, University of Washington, Seattle, WA, USA.
⁸ Departments of Community Health Family Medicine and Neurology, University of Florida, Gainesville, FL, USA.
⁹ Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
¹⁰ Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.
¹¹ Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
¹² Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹³ Department of Exercise Science, California Lutheran University, Thousand Oaks, CA, USA.
¹⁴ Department of Health, Exercise & Sports Sciences, University of New Mexico, Albuquerque, NM, USA.
¹⁵ Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹⁶ Major League Soccer, Princeton, NJ, USA.
¹⁷ Department of Orthopedics and Sports Medicine, United States Naval Academy, Annapolis, MD, USA.
¹⁸ Center for Neurotrauma Research, Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
¹⁹ Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
²⁰ Orthopaedics and Sports Medicine, Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

PMID: 37751028
DOI: 10.1007/s10439-023-03367-y

Abstract

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.

Keywords: Gender; Mild traumatic brain injury; Neurocognitive; Postural stability; Psychological.

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References

1. Rosenthal, J. A., R. E. Foraker, C. L. Collins, and R. D. Comstock. National high school athlete concussion rates from 2005–2006 to 2011–2012. Am. J. Sports Med. 42(7):1710–1715, 2014. https://doi.org/10.1177/0363546514530091 . - DOI - PubMed
1. Kerr, Z. Y., K. G. Roos, A. Djoko, et al. Epidemiologic measures for quantifying the incidence of concussion in National Collegiate Athletic Association sports. J. Athl. Train. 52(3):167–174, 2017. https://doi.org/10.4085/1062-6050-51.6.05 . - DOI - PubMed - PMC
1. O’Connor, K. L., M. M. Baker, S. L. Dalton, T. P. Dompier, S. P. Broglio, and Z. Y. Kerr. Epidemiology of sport-related concussions in high school athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011–2012 through 2013–2014. J. Athl. Train. 52(3):175–185, 2017. https://doi.org/10.4085/1062-6050-52.1.15 . - DOI - PubMed - PMC
1. Chandran, A., A. J. Boltz, S. N. Morris, et al. Epidemiology of concussions in National Collegiate Athletic Association (NCAA) sports: 2014/15–2018/19. Am. J. Sports Med. 50(2):526–536, 2021. https://doi.org/10.1177/03635465211060340 . - DOI - PubMed
1. Combs, P. R., C. B. Ford, K. R. Campbell, K. A. Carneiro, and J. P. Mihalik. Influence of self-reported fatigue and sex on baseline concussion assessment scores. Orthop. J. Sports Med. 7(1):2325967118817515, 2019. https://doi.org/10.1177/2325967118817515 . - DOI - PubMed - PMC

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[1] Rosenthal, J. A., R. E. Foraker, C. L. Collins, and R. D. Comstock. National high school athlete concussion rates from 2005–2006 to 2011–2012. Am. J. Sports Med. 42(7):1710–1715, 2014. https://doi.org/10.1177/0363546514530091 . - DOI - PubMed

[2] Rosenthal, J. A., R. E. Foraker, C. L. Collins, and R. D. Comstock. National high school athlete concussion rates from 2005–2006 to 2011–2012. Am. J. Sports Med. 42(7):1710–1715, 2014. https://doi.org/10.1177/0363546514530091 . - DOI - PubMed

[3] Kerr, Z. Y., K. G. Roos, A. Djoko, et al. Epidemiologic measures for quantifying the incidence of concussion in National Collegiate Athletic Association sports. J. Athl. Train. 52(3):167–174, 2017. https://doi.org/10.4085/1062-6050-51.6.05 . - DOI - PubMed - PMC

[4] Kerr, Z. Y., K. G. Roos, A. Djoko, et al. Epidemiologic measures for quantifying the incidence of concussion in National Collegiate Athletic Association sports. J. Athl. Train. 52(3):167–174, 2017. https://doi.org/10.4085/1062-6050-51.6.05 . - DOI - PubMed - PMC

[5] O’Connor, K. L., M. M. Baker, S. L. Dalton, T. P. Dompier, S. P. Broglio, and Z. Y. Kerr. Epidemiology of sport-related concussions in high school athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011–2012 through 2013–2014. J. Athl. Train. 52(3):175–185, 2017. https://doi.org/10.4085/1062-6050-52.1.15 . - DOI - PubMed - PMC

[6] O’Connor, K. L., M. M. Baker, S. L. Dalton, T. P. Dompier, S. P. Broglio, and Z. Y. Kerr. Epidemiology of sport-related concussions in high school athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011–2012 through 2013–2014. J. Athl. Train. 52(3):175–185, 2017. https://doi.org/10.4085/1062-6050-52.1.15 . - DOI - PubMed - PMC

[7] Chandran, A., A. J. Boltz, S. N. Morris, et al. Epidemiology of concussions in National Collegiate Athletic Association (NCAA) sports: 2014/15–2018/19. Am. J. Sports Med. 50(2):526–536, 2021. https://doi.org/10.1177/03635465211060340 . - DOI - PubMed

[8] Chandran, A., A. J. Boltz, S. N. Morris, et al. Epidemiology of concussions in National Collegiate Athletic Association (NCAA) sports: 2014/15–2018/19. Am. J. Sports Med. 50(2):526–536, 2021. https://doi.org/10.1177/03635465211060340 . - DOI - PubMed

[9] Combs, P. R., C. B. Ford, K. R. Campbell, K. A. Carneiro, and J. P. Mihalik. Influence of self-reported fatigue and sex on baseline concussion assessment scores. Orthop. J. Sports Med. 7(1):2325967118817515, 2019. https://doi.org/10.1177/2325967118817515 . - DOI - PubMed - PMC

[10] Combs, P. R., C. B. Ford, K. R. Campbell, K. A. Carneiro, and J. P. Mihalik. Influence of self-reported fatigue and sex on baseline concussion assessment scores. Orthop. J. Sports Med. 7(1):2325967118817515, 2019. https://doi.org/10.1177/2325967118817515 . - DOI - PubMed - PMC

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Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium

Affiliations

Female Collegiate Athletes' Concussion Characteristics and Recovery Patterns: A Report from the NCAA-DoD CARE Consortium

Authors

Affiliations

Abstract

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References

MeSH terms

Grants and funding

LinkOut - more resources

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Medical