Gender Differences in Concussion Symptoms of High School Soccer Players

Sports-related concussion caused by either direct or indirect force to the head is a form of mild traumatic brain injury (mTBI) that results in a disturbance in brain functioning. This disturbance may affect the athlete’s ability to participate in sports, pursue vocations or experience success academically. Because mTBI is a health concern with need for medical and clinical management, it is imperative to determine which features of concussion influence or impact recovery. These features, or prognostic indicators, include gender and may impact recovery and overall outcomes. The purpose of this study is to determine whether males and females differ in concussive symptoms after sport related injuries. This may ultimately change the way concussions are managed from the sideline, in the emergency department, and during rehabilitation therapies until finally, determination of returning to play. The study design is a retrospective cohort study with data collected from the 2015, 2016, and 2017 soccer seasons from northern Indiana’s South Bend school corporation. Data collection methods consisted of concussion symptom information being collected by athletic trainers (AT) from the time a player sustained a sport related mTBI until the player was asymptomatic. The participants consisted of male and female high school soccer athletes injured during practice or during a game. Male and female players were compared for number of symptoms, severity of symptoms and duration of symptom complaints. The results of the study revealed that females reported an increased number and level of severity of concussion symptoms. Females experienced a longer duration of recovery that is becoming asymptomatic when compared to males.I. INTRODUCTION 1 | Concussion Issues And Recommendations 2 | Gender and Concussive Injuries 2 | Return to Learn and Return to Play 3 | Purpose of Study 4 | Theoretical Framework 4 | II. REVIEW OF THE LITERATURE 6 | Medical Definition of Concussion 6 | Symptoms of Concussion 7 | Sport Related Headache 10 | Sport Related Concussion 11 | Post-Concussive Syndrome 11 | Concussive Injury and the Brain 12 | Neurophysiology of Concussion 12 | Autonomic Dysregulation 13 | Cerebral Blood Flow 14 | Axonal Injury 15 | Neurometabolic Cascade 16 | Loss of Consciousness 17 | Gender Differences in Neurophysiology of Concussion 18 | Gender Differences in Concussion and Symptomology 20 | Concussion Management 23 | Concussion Testing 24 | Neurocognitive Testing 27 | Oculomotor Testing 27 | Academic Impact 28 | The Role of Speech Language Pathology in Concussion Management 31 | Return to Play 32 | Conclusion 34 | III. METHODOLOGY 35 | Research Design 35 | Procedure 35 | Selection of Participants 36 | Instrumentation 36 | Data Collection 37 | IV. RESULTS 38 | Demographics 38 | Symptom Comparisons Day 1 39 | Correlation of Male Symptomology 43 | Correlation of Female Symptomology 44 | Male Symptom Duration 45 | Female Symptom Duration 46 | V. DISCUSSION 48 | Current Research 48 | Player Understanding of Concussion 49 | Co-Morbid Conditions 49 | Influence of Method on Symptom Reporting 51 | Gender Differences in Reporting 51 | Limitations 53 | Deliminations 54 | Unexpected Results 54 | Future Directions 55 | REFERENCES 57 | APPENDIX A: Memorial Hospital Internal Review Board 79 | APPENDIX B: Memorial Hospital Internal Review Board 81 | APPENDIX C: Sports Concussion Assessment Tool-3rd Edition 83 | APPENDIX D: Sport Concussion Assessment Tool-5th Edition 88 | APPENDIX E: Concussion Policy and Procedure Document Beacon | Medical Group Sports Medicine 97 | APPENDIX F: Academic Concussion Recommendations Beacon | Medical Group 102 | APPENDIX G: Data Collection Form 104 | APPENDIX H: Kruskal-Wallis H Ranking of Symptoms Comparing Male | and Female Self-reported Concussion Symptoms 106 | APPENDIX I: Spearmans rho Male Symptom Correlations 108 | APPENDIX J: Spearmans rho Female Symptom Correlations 110 |Lamb, KatherineGorham-Rowan, MaryHannibal, ReneeYoungs, William H.da Cruz, Becky K.Ph.D.Speech-language Patholog