SYMPTOM PROFILES AND BALANCE CONTROL AFTER CONCUSSION AMONG FEMALE YOUTH ARTISTIC ATHLETES

BACKGROUND: Collision and contact sports are often the focus of concussion research; however, concussions also occur in artistic sports, including gymnastics and cheerleading. Few studies have examined how concussion presents in female youth artistic athletes. Specifically, the effects of concussion on symptom profiles and balance performance among these athletes have yet to be investigated. HYPOTHESIS/PURPOSE: The purpose of our investigation was to compare post-concussion symptom profiles and balance measures among female youth artistic athletes relative to ball sport athletes. We hypothesized that artistic athletes would have similar concussion symptom profiles to ball sport athletes, but that artistic athletes would display better balance due to the demands of their sport. METHODS: Female youth athletes ages 6-18 years who sustained a concussion during gymnastics or cheerleading (i.e. “artistic athletes”) or during volleyball or basketball (i.e. “ball sport athletes”) were seen within 3 weeks of injury. We compared performance between the two groups on measures of self-reported symptom frequency using the Health and Behavior Inventory (HBI), headache severity, and balance control using the Balance Error Scoring System (BESS), tandem gait, and Romberg tests. We compared outcome variables between groups using univariable Mann-Whitney U and Fisher’s exact tests. We constructed multivariable regression models to account for potential confounding variables, defined as those that demonstrated a difference between groups of p < 0.2. RESULTS: Twenty-seven artistic athletes and forty-nine ball sport athletes sustained a concussion during the study period of 2015-2017. The artistic athletes were slightly younger, seen later for initial evaluation after injury, had a lower proportion with prior concussion history, and a lower proportion with pre-injury history of migraine compared to ball sport athletes (Table 1). Thus, these four variables were included as covariates in subsequent regression models. After adjusting for the independent effect of these potential confounding variables, we observed that artistic athletes performed the BESS tandem stance foam condition with significantly fewer errors than ball sport athletes (Table 2). Artistic female athletes demonstrated a higher, yet not statistically significant, headache severity than ball sport female athletes. CONCLUSION: Female artistic athletes had similar symptom profiles to ball sport athletes. Although artistic athletes performed better on BESS tandem stance foam condition, their other measures of balance control were not significantly different from ball sport athletes. This suggests that although their sports may require higher levels of balance, artistic athletes’ performance on post-concussion balance tests may be similar to athletes of other disciplines. Tables: