Females Athletes Require Longer Post-Concussion Recovery


July 27, 2020

On average, high school athletes with concussion take 1 month to return to play, illustrating that the message that prolonged rest is needed after a head impact is getting through, new research suggests.

However, findings from a cohort study of more than 300 high school athletes who sustained at least one concussion also showed that females and those with a history of previous concussion took longer to return to play.

“Our results show that high school athletes with concussion have a high prevalence of previous concussion — around 33%. Coaches and physicians need to be aware that these individuals may take longer to recover,” lead author Toufic Jildeh, MD, Henry Ford Hospital, Detroit, Michigan, told Medscape Medical News.

Jildeh noted that clinicians and coaches should also be aware that female athletes may be more susceptible to concussion.

“We need to be more sensitive to concussion-like complaints in females and they should have a lower threshold for being taken out of the game,” he said.

“It has been shown before that females with concussion have reduced visual memory, processing speed, and reaction times vs males with concussion. This fits in with our observations of longer times to return to play for females,” Jildeh added.

The findings are published in the July/August issue of Orthopedics.

Hockey, Football, Soccer

The researchers analyzed records of 357 consecutive youth patients who sustained concussions and presented to the Henry Ford Hospital in Detroit between September 2013 and December 2016.

The average age at injury was 15.5 years (age range 14-18 years). In addition, 62% of patients were boys, 6.7% reported a loss of consciousness, and 14.3% reported having had amnesia. The most common sport of injury was football (27.7%), followed by hockey and soccer.

To assist in the management of concussions, neuropsychological testing is routinely implemented primarily using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) score, which includes a battery of 6 neuropsychometric tests, Jildeh noted.

The score at time of concussion is compared with a previous baseline score from the individual taken at the beginning of the season. If a baseline score is not available, a normative value is used.

“These scores are then used to assess recovery and when a patient is ready to return to play,” said Jildeh.

A total of 33% of participants had had a previous concussion, including 30.6% of football players, 48.1% of hockey players, and 33.3% of soccer players.

Among concussions sustained during the study period, hockey players had the highest rate of loss of consciousness and amnesia (10.4% and 15.6%, respectively).

Score Disparities

On average, athletes required 30.4 days of recovery prior to returning to sport. Those who sustained a recurrent concussion had a longer recovery (35.3 days), although this was not statistically significant (P = .77).


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