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      Sex Differences in High School Athletes' Knowledge of Sport-Related Concussion Symptoms and Reporting Behaviors

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      Journal of Athletic Training
      Journal of Athletic Training/NATA

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          Abstract

          <div class="section"> <a class="named-anchor" id="st1"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e123">Context: </h5> <p id="d9557537e125">Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes. </p> </div><div class="section"> <a class="named-anchor" id="st2"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e128">Objective: </h5> <p id="d9557537e130">To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes. </p> </div><div class="section"> <a class="named-anchor" id="st3"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e133">Design: </h5> <p id="d9557537e135">Cross-sectional study.</p> </div><div class="section"> <a class="named-anchor" id="st4"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e138">Setting: </h5> <p id="d9557537e140">Survey.</p> </div><div class="section"> <a class="named-anchor" id="st5"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e143">Patients or Other Participants: </h5> <p id="d9557537e145">A total of 288 athletes across 7 sports (198 males [68.8%] and 90 females [31.2%]).</p> </div><div class="section"> <a class="named-anchor" id="st6"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e148">Main Outcome Measure(s): </h5> <p id="d9557537e150">A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure. </p> </div><div class="section"> <a class="named-anchor" id="st7"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e153">Results: </h5> <p id="d9557537e155">A sex difference in total SRC symptom knowledge was found ( <i>F</i> <sub>286</sub> = 4.97, <i>P</i> = .03, d = 0.26). Female high school athletes had more total SRC symptom knowledge (mean ± standard deviation = 15.06 ± 2.63; 95% confidence interval = 14.54, 15.57) than males (14.36 ± 2.76; 95% confidence interval = 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC. </p> </div><div class="section"> <a class="named-anchor" id="st8"> <!-- named anchor --> </a> <h5 class="section-title" id="d9557537e167">Conclusions: </h5> <p id="d9557537e169">High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure. </p> </div>

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          Most cited references21

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          National Athletic Trainers' Association position statement: management of sport concussion.

          To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions.
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            The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion.

            Researchers have begun to focus on age and sex differences in concussion outcomes. Results suggest that younger athletes and female athletes may take longer to recover from a concussion. However, little is known about the interactive effects of age and sex on symptoms, neurocognitive testing (NCT), and postural stability. The purpose of the study was to examine sex and age differences in symptoms, NCT, and postural stability following concussion. We hypothesized that high school and female athletes would have worse symptoms, NCT, and postural stability than college and male athletes, respectively. Cohort study; Level of evidence, 2. A total of 296 concussed athletes from a multistate, 2-year study were enrolled in this study. Participants completed the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) and Post-Concussion Symptom Scale (PCSS) at baseline and again at 2, 7, and 14 days after concussion. Participants completed the Balance Error Scoring System (BESS) at 1, 2, and 3 days after concussion. Female athletes performed worse than male athletes on visual memory (mean, 65.1% and 70.1%, respectively; P = .049) and reported more symptoms (mean, 14.4 and 10.1, respectively) after concussion (P = .035). High school athletes performed worse than college athletes on verbal (mean, 78.8% and 82.7%, respectively; P = .001) and visual (mean, 65.8% and 69.4%, respectively; P = .01) memory. High school athletes were still impaired on verbal memory 7 days after concussion compared with collegiate athletes (P = .001). High school male athletes scored worse on the BESS than college male athletes (mean, 18.8 and 13.0, respectively; P = .001). College female athletes scored worse on the BESS than high school female athletes (mean, 21.1 and 16.9, respectively; P = .001). The results of the current study supported age differences in memory and sex differences in memory and symptoms and an interaction between age and sex on postural stability after concussion that warrant consideration from clinicians and researchers when interpreting symptoms, specific components of NCT, and postural stability tests. Future research should develop and assess interventions tailored to age and sex differences and include younger (<14 years) participants.
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              Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study.

              Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors.
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                Author and article information

                Journal
                Journal of Athletic Training
                Journal of Athletic Training
                Journal of Athletic Training/NATA
                1062-6050
                July 2017
                July 2017
                : 52
                : 7
                : 682-688
                Article
                10.4085/1062-6050-52.3.06
                5517124
                28561626
                6876395e-6931-4152-9931-a0ceed16cbec
                © 2017
                History

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