Concussion-like symptom evaluation and modifying factors for assessment in collegiate club-sport athletes.

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 modifying factor effects of sex, concussion history, diagnosed attention disabilities (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: 1034 collegiate club-sport athletes (N=649 male, 62.7%) from 29 different sports at a single institution.

MAIN OUTCOME MEASURES: Chart reviews were completed for club-sport athletes who completed athlete background and symptom evaluation on the Sport Concussion Assessment Tool - 5th edition (SCAT5) as baseline concussion assessment during a single academic year. Demographics (e.g., age, sex, sport), background medical information (e.g., concussion history, ADHD, etc.) and symptom evaluation, consisting of individual 22-item symptom reporting, total number of symptoms (TS), symptom severity (SS) scores, and symptom-factors (e.g., physical, cognitive, insomnia, and emotional) were analyzed.

RESULTS: 68% of club-sport athletes were asymptomatic on baseline symptom reporting, with 3-12% reporting mild symptoms and ≤4% reporting moderate and severe symptoms. Modifier groups differed with higher TS and SS in females (p<.001), individuals reporting a history of concussion (p<.001), and those with ADHD (TS p=.04, SS p =.02). Similar significant findings were noted for females and the history of concussion group on all 4 symptom-factors, however collision/contact sports also reported greater cognitive (p=.03) and insomnia (p=.02) factors. Those with ADHD reported higher cognitive (p<.001) factors.

CONCLUSIONS: Normative symptoms were produced for a collegiate club-sport sample, revealing ~70% asymptomatic reporting. Higher TS and SS scores were reported by females and those with a history of concussion. Cognitive-specific symptoms were greater in those diagnosed with ADHD and who participated in collision/contact sports.