Factors Associated With Self-Reported Concussion History in Middle School Athletes

Clin J Sport Med. 2018 Apr;

[Epub ahead of print](27-Mar):.

Terry, D. P., M. Wojtowicz, N. E. Cook, B. A. Maxwell, R. Zafonte, T. Seifert, N. D. Silverberg, P. D. Berkner and G. L. Iverson.


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OBJECTIVE: Identifying personal characteristics associated with sustaining a concussion is of great interest, yet only a few have examined this in children. The purpose of this study was to examine the association between sex, neurodevelopmental disorders, health history, and lifetime history of self-reported concussion in 12- and 13-year-old athletes. DESIGN: Cross-sectional study. SETTING: Middle schools. PARTICIPANTS: Participants were 1744 twelve- and thirteen-year-old student athletes who completed preseason Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) testing, including a self-report questionnaire about previous concussions, developmental diagnoses, and previous medical treatment. INDEPENDENT VARIABLES: Age, sex, attention-deficit/hyperactivity disorder (ADHD), learning disabilities (LDs), and previous treatment for migraine. MAIN OUTCOME MEASURES: Self-reported history of concussion. RESULTS: A minority of athletes (13.7%) reported previous concussions (1 concussion, n = 181; 2 concussions, n = 41; and 3+ concussions, n = 17). A small proportion reported a history of ADHD (4.4%), LD (2.8%) or migraine treatment (4.0%). Higher rates of self-reported previous concussions were associated with male sex (16.9% vs 9.1%; chi(1) = 21.47, P < 0.001) and previous migraine treatment (31.9% vs 13.0%; chi(1) = 20.08, P < 0.001). There were no differences in self-reported concussion history between 12- and 13-year olds (P = 0.18) and those with/without ADHD (P = 0.41) or LDs (P = 0.06). The overall logistic regression model was statistically significant (chi(5) = 42.01, P < 0.001) but explained only 4.3% of the variance. Previous treatment for migraine (P < 0.001, Exp(B) = 3.30) and male sex (P < 0.001, Exp(B) = 2.06) were independently associated with a self-reported concussion history, whereas age, LD, and ADHD were not (P’s > 0.05). CONCLUSIONS: Male sex and previous migraine treatment were associated with higher rates of self-reported previous concussions in both independent and multivariate models in middle school athletes, whereas age, ADHD, and LDs were not.

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