Baseline Evaluation of Concussion-Like Symptoms and Modifying Factors in Collegiate Club-Sport Athletes

Abstract

Context Collegiate club-sport athletes participate in a variety of competitive sports and have been understudied in the concussion literature. Baseline performance measures are warranted to better understand assessment and management. Objective To quantify normative values and the effects of modifying factors sex, concussion history, diagnosed attention disabilities (attention-deficit/hyperactivity disorder [ADHD]), and sport type on baseline symptom evaluation among collegiate club-sport athletes. Design Cross-sectional study. Setting Retrospective chart review. Patients or Other Participants A total of 1034 collegiate club-sport athletes (N = 649 males, 62.7%) from 29 sports at a single institution. Main Outcome Measure(s) Chart reviews were conducted for club-sport athletes who completed athlete background and symptom information on the Sport Concussion Assessment Tool—5th edition as a baseline concussion assessment during a single academic year. Demographics (eg, age, sex, sport), background medical information (eg, concussion history, ADHD), and symptom evaluation, consisting of individual 22-item symptom reports, the total number of symptoms, symptom severity scores, and symptom factors (eg, physical, cognitive, insomnia, and emotional), were analyzed. Results On baseline symptom reporting, 68% of club-sport athletes were asymptomatic, with mild symptoms described by 3% to 12% and moderate or severe symptoms by ≤4%. Modifier groups differed with a higher total number of symptoms and symptom severity in females (P < .001), individuals reporting a history of concussion (P < .001), and those with ADHD (total number P = .04, symptom severity P = .02). Similar significant findings were noted for females and the history of concussion group on all 4 symptom factors; however, those in collision or contact sports also indicated greater cognitive (P = .03) and insomnia (P = .02) factors. Those with ADHD endorsed more cognitive (P < .001) factors. Conclusions Normative symptoms for a collegiate club-sport sample revealed approximately 70% were asymptomatic. Higher total number of symptoms and symptom severity were demonstrated by females and those with a history of concussion. Cognitive-specific symptoms were greater in those diagnosed with ADHD and those who participated in collision or contact sports.