Audio-vestibular Concussion Symptoms And Symptom Resolution Time In Helmeted And Non-helmeted NCAA Sports: 2014/15 - 2018/19

Abstract

PURPOSE: Audio-vestibular symptoms (AV symptom) are commonly endorsed following a sport-related concussion (SRC) and are associated with longer symptom resolution time (SRT). Despite changes in helmet designs that have resulted in reduced SRC rates, it is not clear if or how they may influence AV symptom expression and subsequent SRT. Thus, we examined AV symptom endorsement and SRT following AV symptom endorsement in helmeted and non-helmeted National Collegiate Athletic Sports (NCAA) sports. METHODS: SRCs reported to the NCAA Injury Surveillance Program by athletic trainers between 2014/15-2018/19 were analyzed. Helmeted sports (HELM) included Men’s Football/Lacrosse, Men’s/Women’s Ice Hockey; and Non-helmeted sports (NoHELM) included Men’s/Women’s Basketball/Cross-Country/Tennis/Track & Field/Soccer, Women’s Gymnastics/Volleyball. Sensitivity to noise, balance issues, tinnitus, disorientation, and dizziness were classified as AV symptoms. Summary statistics (frequencies (%s), medians, interquartile ranges) were used to describe the sample. Wilcoxon rank sum tests were used to detect group differences in AV symptom endorsement, and SRT (in SRCs with ≥1 AV symptom) between HELM and NoHELM SRCs. Ordinal logistic regression models identified differential odds of greater AV symptom count, and longer SRT (categorized as: ≤14, 15-28, >28 days) between SRCs in HELM and NoHELM sports (adjusting for AV symptom count). All models were parametrized to adjust for covariate (sex, class year, event type, and injury mechanism) effects, and effect estimates with 95% CIs excluding 1.0 were deemed statistically significant. RESULTS: Overall, 1,084 SRCs were analyzed, and most were in HELM (67%). Dizziness was the most prevalent AV symptom endorsed in both HELM (60%) and NoHELM (63%) SRCs. We observed no group differences in AV symptom count or SRT between NoHELM and HELM SRCs. SRCs in HELM (compared to NoHELM) were not associated with odds of greater counts of AV symptoms. SRCs (with ≥1 AV symptom) in HELM (compared to NoHELM) were associated with higher odds of longer SRT (ORAdj. = 2.1, 95%CI = 1.2-3.9). CONCLUSIONS: The number of AV symptoms endorsed following a SRC was not influenced by sport type (HELM, NoHELM). Adjusting for AV symptoms endorsed, athletes that sustained SRCs in HELM had higher odds of longer SRT.