A Portrait of the Concussed Student-Athlete: Grade and Sex Affect Presentation of Symptoms


Courtney Jensen: 0000-0001-9774-0694

Document Type

Conference Presentation


Health, Exercise, and Sport Sciences Department

Conference Title

2018 ACSM National Conference


American College of Sports Medicine (ACSM)


Minneapolis, MN

Conference Dates

May 29 - June 2, 2018

Date of Presentation

May 2018

Journal Publication

Medicine and Science in Sports and Exercise









Publication Date



It is important to appreciate the enormous diversity in the presentation and prognosis of sport-related concussions (SRC) in athletes. Duration of recovery is highly variable and partly attributable to injury severity, but a comprehensive evaluation must also include age and sex. Research on the interaction of these variables among youth athletes is limited. PURPOSE: To evaluate the effect of age and sex on the presentation of SRC symptoms in student-athletes undergoing prolonged recovery. METHODS: A sample of athletes from middle school to college (n=76) were evaluated for persistent symptoms of SRC. Cognitive function was measured using the ImPACT test; behavior and attitudes were collected via the Behavior Assessment System for Children (BASC) questionnaire. Independent-samples t tests, chi-squared tests, and multivariate analyses with a Bonferroni correction measured differences between sexes and scholastic grades on cognitive, behavioral, and functional assessments. RESULTS: Subjects were 16.2 ± 2.3 years of age; 56.6% of patients were male. Men and women expressed no differences in age (p=0.780), number of previous concussions (p=0.231), or duration of current symptoms (p=0.445). Men tested higher in verbal memory (p=0.036), visual motor speed (p=0.003), and cognitive efficiency (reaction time and accuracy; p=0.007). Women reported better attitudes toward school (p=0.005) and teachers (p=0.043). College athletes sustained more previous concussions (2.6) than middle school (1.0) and high school (1.0) athletes (p=0.016), but high school athletes expressed a trend for more co-occurring diagnoses (1.4) than middle school (0.9) and college (0.6) athletes (p=0.057). The difference between high school and college was significant (p=0.029). Regarding performance, there was a difference between grade levels in the cognitive efficiency index with middle school athletes scoring significantly lower than high school and college athletes (p=0.022). CONCLUSIONS: When youth athletes experience SRC, the sex and age of the athlete is associated with important differences in attitudes, memory, and functional capacities. Proper evaluation of a concussed athlete must consider the role that age and sex play on the diagnosis of injury severity and the expectations of recovery.