This study was designed to investigate differences in recovery in male and female soccer athletes.
Soccer players with a history of concussion will perform worse on neurocognitive testing than players without a history of concussion. Furthermore, female athletes will demonstrate poorer performance on neurocognitive testing than male athletes.
Cohort study (prognosis): Level of evidence, 2.
Computer-based neuropsychological testing using reaction time, memory, and visual motor-speed composite scores of the ImPACT test battery was performed postconcussion in soccer players ranging in age from 8 to 24 years (N = 234; 141 females, 93 males). A multivariate analysis of variance was conducted to examine group differences in neurocognitive performance between male and female athletes with and without a history of concussion.
Soccer players with a history of at least 1 previous concussion performed significantly worse on ImPACT than those who had not sustained a prior concussion (F = 2.92, P =.03). In addition, female soccer players performed worse on neurocognitive testing (F = 2.72, P =.05) and also reported more symptoms (F = 20.1, P =.00001) than male soccer players. There was no significant difference in body mass index between male and female players (F =.04, P =.85).
A history of concussion and gender may account for significant differences in postconcussive neurocognitive test scores in soccer players and may play a role in determining recovery. These differences do not appear to reflect differences in mass between genders and may be related to other gender-specific factors that deserve further study.
"With regard to neurocognitive testing for concussion among youth, large samples stratified by age are of particular importance as cognitive maturation occurs dramatically during adolescence (Casey, Giedd, & Thomas, 2000; Yurgelun-Todd, 2007). Gender-based data are also important as men and women perform differently on neurocognitive measures postconcussion (Colvin et al., 2009; Covassin, Elbin, Harris, Parker, & Kontos, 2012; Covassin, Elbin, Larson, & Kontos, 2012). "
[Show abstract][Hide abstract] ABSTRACT: The neurocognitive testing of sports concussion for injury management and return-to-play decisions has long been considered the gold standard in evaluation of the injury. Computerized testing batteries are frequently employed, with the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) being the most used of all the current testing platforms to evaluate concussion. ImPACT's clinical report yields four normed composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) and another composite score that is not normed but is used as a validity measure (Impulse Control), as well as their corresponding subtest scores, which are not normed. The current study provides normative data on each of the subtests used to calculate the composite scores. Normative data are separated by gender for athletes aged 13 to 21 years old and are stratified by the norm age brackets already employed by the ImPACT. These norms may be helpful in the interpretation of the ImPACT clinical report and further delineation of areas of neurocognitive dysfunction.
"Straume-Naesheim et al. (2009) recorded a reduction in neuropsychological performance in football players who experienced one or more head impacts in comparison to their own baseline, but when the results were compared with the test manufacturer's normative values, no impairment was detected (Table I). Colvin et al. (2009) reported that football player with a history of at least one concussion performed significantly worse on ImPACT than those without a prior concussion, and female players worse than their male counterparts (Table I). If no baseline tests are available, it is important to compare the post-injury results to robust normative measures (Echemendia et al., 2013). "
[Show abstract][Hide abstract] ABSTRACT: Abstract A concussion is a rare but potentially serious injury of football players. Thus, an immediate and valid diagnosis, estimate of severity and therapeutic management is required. To summarise the published information on management of concussion with respect to a safe return to play (RTP), a literature search was conducted. Current guidelines on concussion in sports and significant studies on concussion in football were analysed. After concussion, management and RTP decision should remain in the area of clinical judgement on an individualised basis according to the current international guidelines. If a concussion is suspected, the player should not be allowed to RTP the same day. The RTP programme should follow a gradual step-wise procedure. A concussed player should not RTP unless he/she is asymptomatic and the neurological and neuropsychological examinations are normal. Untimely RTP bears an increased risk of sustaining another more severe brain injury and repetitive brain injury of long-term sequelae. In football, the management of concussion should primarily follow the recommendations proposed by the Concussion in Sports Group. Information and education of players and their medical and coaching team help to protect the players' health. Future studies on concussion should include validated and detailed information on RTP protocols.
"Reports of sex differences in neuropsychological deficits have also revealed mixed findings, with some authors reporting greater impairment for concussed females in some neurocognitive domains (Broshek et al. 2005; Colvin et al. 2009) and others appearing to report no injury-related sex differences in neuropsychological functioning (e.g., sex differences in neuropsychological performance reported by Covassin et al. 2007, 2012 reflected main effects of sex across pre-and post-injury time points and therefore did not appear to be injury related). A large meta-analysis of 3,801 concussed athletes and 5,631 controls found greater post-concussive neuropsychological deficits in females at their first postinjury assessment (1–10 days after injury) after accounting for time since injury, comparison group (personal baseline vs. controls), and age group (Dougan et al. 2013). "
[Show abstract][Hide abstract] ABSTRACT: Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury's defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.
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