Dataset Information

A Prospective Study of Concussions and Health Outcomes in High School Football Players.

ABSTRACT:

Context

Football is the most popular sport among US high school students and among the highest for sport-related concussion (SRC) incidence. Limited data detail how SRCs affect high school football players' psychosocial and health status beyond short-term injury recovery.

Objective

To longitudinally assess how SRCs affected symptoms, depression, and health-related quality of life (HRQoL) in high school football players up to 12 months after SRC.

Design

Prospective cohort study.

Setting

Thirty-one Wisconsin high schools.

Patients or other participants

A total of 1176 interscholastic football players (age = 16.0 ± 1.2 years).

Main outcome measure(s)

Participants completed the Post-concussion Symptom Scale (PCSS) from the Sport Concussion Assessment Tool 3 (SCAT3), Patient Health Questionnaire-9 (PHQ-9) for depression, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for HRQoL at enrollment. Participants who sustained an SRC repeated each measure within 72 hours of their injury (onset) and at 7 days (D7), return to play (RTP), and 3 months (M3), 6 months (M6), and 12 months (M12) after SRC. Scores at each time point were compared with each participant's baseline using linear mixed models for repeated measures while controlling for age and previous SRC with participant as a random effect.

Results

Sixty-two participants sustained an SRC. Participants reported a higher number of PCSS symptoms, greater symptom severity, and lower PedsQL physical summary scores at onset and D7. From RTP through M12, PCSS symptoms, PCSS severity scores, PedsQL total scores, physical summary, and psychosocial summary were unchanged or improved relative to baseline. The PHQ-9 scores were not higher than baseline at any post-SRC interval.

Conclusions

High school football players in this study who sustained an SRC described no sustained adverse health outcomes (increased PCSS symptoms or symptom severity, increased depression symptoms, or lower HRQoL) after their RTP through M12 after injury.

SUBMITTER: McGuine TA

PROVIDER: S-EPMC7594612 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionRepetitive, subconcussive events may adversely affect the brain and cognition during sensitive periods of development. Prevention of neurocognitive consequences of concussion in high school football is therefore an important public health priority. We aimed to identify the player positions and demographic, behavioral, cognitive, and impact characteristics that predict the frequency and acceleration of head impacts in high school football players.MethodsIn this prospective study, three cohorts of adolescent male athletes (N = 53, 28.3% Hispanic) were recruited over three successive seasons in a high school American football program. Demographic and cognitive functioning were assessed at baseline prior to participating in football. Helmet sensors recorded impact frequency and acceleration. Each head impact was captured on film from five different angles. Research staff verified and characterized on-field impacts. Player-level Poisson regressions and year-level and impact-level linear mixed-effect models were used to determine demographic, behavioral, cognitive, and impact characteristics as predictors of impact frequency and acceleration.Results4,678 valid impacts were recorded. Impact frequency positively associated with baseline symptoms of hyperactivity-impulsivity [β(SE) = 1.05 impacts per year per unit of symptom severity (1.00), p = 0.01] and inattentiveness [β(SE) = 1.003 impacts per year per T-score unit (1.001), p = 0.01]. Compared to quarterbacks, the highest acceleration impacts were sustained by kickers/punters [β(SE) = 21.5 g's higher (7.1), p = 0.002], kick/punt returners [β(SE) = 9.3 g's higher (4.4), p = 0.03], and defensive backs [β(SE) = 4.9 g's higher (2.5), p = 0.05]. Impacts were more frequent in the second [β(SE) = 33.4 impacts (14.2), p = 0.02)] and third [β(SE) = 50.9 impacts (20.1), p = 0.01] year of play. Acceleration was highest in top-of-the-head impacts [β(SE) = 4.4 g's higher (0.8), p<0.001].ConclusionIncluding screening questions for Attention-Deficit/Hyperactivity Disorder in pre-participation evaluations can help identify a subset of prospective football players who may be at risk for increased head impacts. Position-specific strategies to modify kickoffs and correct tackling and blocking may also reduce impact burden.

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