Authors: Gillian Hotz PhD1, Jacob R. Griffin2, Hengyi Ke3, Raymond Crittenden IV2, Abraham Chileuitt MD4
1Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, USA
2KiDZ Neuroscience Center, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
3Department of Public Health, Division of Biostatistics, University of Miami Miller School of Medicine, Miami, FL, USA
4Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
Gillian Hotz, Ph.D.
1095 NW 14th Ter
Miami, FL 33136
Gillian A. Hotz, PhD is a research professor at the University of Miami Miller School of Medicine and a nationally recognized behavioral neuroscientist and expert in pediatric and adult neurotrauma, concussion management, and neurorehabilitation. Dr. Hotz is the director of the KiDZ Neuroscience Center, WalkSafe, and BikeSafe programs.
Return to Play and Learn: Findings from a Countywide High School Sports-Related Concussion Program
To report return to play (RTP) and learn (RTL) findings of high school athletes with a sports-related concussion (SRC) from a 10-year injury surveillance system. The goal was also to explore differences between athletes who received and did not receive academic accommodations.
SRC data was entered into a REDCap database by certified athletic trainers (ATs) at 35 public high schools in Miami-Dade County (MDC). A required 6 Steps to Safe Play concussion protocol was implemented between 2012 to 2022. Concussion Clinic data was also reported for as well as symptom scores of post-injury ImPACT retesting.
From review and analysis of the ImPACT retesting scores, the most common symptoms reported included; headache (54.0%), difficulty concentrating (35.0%), sensitivity to light (34.6%), and dizziness (30.5%). Overall, female athletes reported a higher symptom count and severity on post-injury ImPACT assessments than males (7 vs. 4 total symptoms score; p < 0.001), and all but 4 of the 22 reportable symptoms listed on the symptom inventory (vomiting, fatigue, numbness/tingling, and difficulty remembering) were significant (p < 0.05) between males and females. Despite experiencing a greater number of overall SRCs, athletes playing football had a smaller average (p < 0.001) ImPACT total symptom score than athletes playing other sports (10.9 vs. 14.2). Those seen in clinic and receiving academic accommodations were less likely to RTP, have a greater (p < 0.05) ImPACT total symptom score, more days between injury date and post-ImPACT testing, and a greater number of days until returning to play than athletes not academically accommodated.
It is important for concussion providers to identify and monitor symptoms post-SRC. Study findings report that high school female athletes report more symptoms following an SRC and that appropriate academic accommodations should be included when necessary to ensure athletes recover in a safe and timely manner. Understanding how SRC symptoms vary based on an athlete’s circumstances can help in managing SRC and making better RTL and RTL decisions.
Application In Sports
Academic accommodations, when appropriate, should be incorporated and implemented in an athlete’s recovery plan to help them safely return to the field and classroom after an SRC.
Key Words: Concussion, Adolescent, Accommodations, Symptoms