Effects of Sport Related Concussion on Academic Performance in High School Athletes

Abstract

Background. Concussive impacts to the head are a natural part of most athletic competition. Even in sports that do not permit player contact, incidental contact that can result in concussion often occurs. This dissertation addresses the general hypothesis that sport related concussions have a negative impact on academic performance in high school athletes. Study Design. A systematic review of current literature on the post-acute neurocognitive effects of concussion provides an introduction to the importance of this study. A retrospective cohort of athletes participating in school sports in a public school district is assessed for changes in school attendance and academic performance following concussion compared to ankle or leg injury. Methods. The systematic review included meta-analytic methods. Analysis of the retrospective cohort included longitudinal graphical and multivariable random coefficient methods that characterized changes in academic performance over time in high school athletes with and without concussion. Random coefficient models were used to assess effect modification by predictor variables including gender and age. Results. Researchers have shown that adolescent athletes experience a range of neurocognitive symptoms six or more days following concussion injury. In the retrospective cohort analyses, athletes with concussion injuries have greater odd of being grade 9 (OR=2.2, p<0.001, 95%CI 1.5-3.2) or grade 10 (OR 2.1, p<0.001, 95%CI 1.5-3.1) than grade 12 and had greater odds of an increase in the number of days absent from school (OR=1.7, p<0.011, 95%CI 1.3-2.2) when compared to athletes with ankle or leg injury. Analyses of a subgroup of younger athletes (grades 9 and 10) with more severe injuries indicate a 16% greater decline in academic performance for the group with concussion injury than those with ankle or leg injury (coeff= -0.18, p=0.017, 95% CI= -0.32 to -0.03). Conclusions. These analyses suggest that young athletes with concussion injury are at risk for decline in academic performance. Increased absence from school results in decreased instruction time, social isolation, and other factors that may negatively impact academic achievement. Future research is warranted, examining academic performance in high school athletes with concussion injury.%%%%Ph.D., Public Health – Drexel University, 2014