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Sex Differences in Athletic Trainer Coverage and Recovery After Sport-Related Concussion in High School Athletes
Kristen Williams1,2, Samuel Finch1,3, Anna J Peterson1,2
1Vanderbilt Sports Concussion Center, Vanderbilt University Medical Center, Nashville, TN.
Context:
Several factors influence recovery times after sport-related concussion (SRC) in adolescent athletes. Sex (male versus female) and on-field evaluation by an athletic trainer (AT) have been shown to affect recovery, yet the interaction between these variables has not been evaluated.
Objectives:
To investigate the associations between (1) athlete sex and on-field AT evaluation, (2) athlete sex and recovery times after SRC, and (3) the interaction between sex, on-field evaluations by an AT, and recovery. Demographics, medical history, and initial presentation variables were reported for the cohort, and group differences (male versus female) were presented.
Design:
Retrospective cohort study.
Setting:
Regional sport concussion center.
Patients Or Other Participants:
Adolescent athletes aged 14 to 18 years evaluated at a regional concussion center between November 2017 and April 2022.
Main Outcome Measures:
Primary exposure variables were sex and receiving an on-field AT evaluation. Primary outcomes were time to return to learn, symptom resolution, and return to play, measured in days since injury.
Results:
A total of 832 athletes (average age = 16.2 ± 1.2 years) were included, of whom 279 (33.5%) were female. A significantly higher percentage of males received an on-field AT evaluation compared with females (40.3% versus 32.3%, χ2 = 8.677, P = .013). Males presented with lower initial Post-Concussion Symptom Scale scores compared with females (21.4 ± 21.0 versus 34.9 ± 26.5, t = 7.448, P = .001), although recovery timelines did not differ. In a 2-way analysis of variance, receiving an on-field AT evaluation was associated with a shorter time to symptom resolution (21.6 ± 23.6 versus 27.8 ± 23.2, P = .01), measured in days, but there was no interaction between sex and on-field AT evaluation (F 1,462 = 0.011, P = .92).
Conclusions:
Males received an on-field AT evaluation more often than females. Receiving an on-field AT evaluation was significantly associated with a shorter time to symptom resolution after an SRC; this association did not differ between sexes.
