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Abstract Details

Impact of Playing Surface on Concussion Symptoms in Young American Football Players
Epidemiology
P1 - Poster Session 1 (7:00 AM-3:15 PM)
035
To identify differences in symptoms following sports-related concussion (SRC) on natural grass versus artificial turf in youth and adolescent football players.
There is continued interest in reducing risk of SRC in football, with playing surface being one potentially modifiable factor. It is estimated that 15-30% of concussions result from helmet-to-ground contact, and some studies have suggested a higher incidence of SRC on grass in competitive contact sports compared to turf. To our knowledge, our study is the first to investigate reported post-concussive symptoms after SRC as they relate to playing surface.
Data were prospectively collected from the North Texas Concussion Registry (ConTex), a longitudinal multi-institutional concussion database. We selected male football players between the ages of 10 and 24 who sustained a helmet-to-ground SRC (GCS 13-15) on either grass or turf. Pre-injury information and post-concussive symptoms (Graded Symptom Checklist from the SCAT-5) were collected at an initial in-person visit within 2 weeks of injury and via electronic follow up at 3 months. 
Fifty-eight participants were included (grass=32, turf=26), and groups were similar in age (p=0.089), time since injury (p=0.500), history of headache (χ2=0.167), and prior history of concussion (χ2=0.868). Athletes who sustained SRC on grass reported significantly higher scores on the Graded Symptom Checklist (p=0.018, mean 26.0 vs 11.4) and higher numbers of distinct symptoms (p=0.013, mean 10.2 vs 5.5) compared to those who sustained SRC on turf. Symptoms that were rated significantly higher after SRC on grass included headache (p=0.010), phonophobia (p=0.014), dizziness (p=0.001), fatigue (p=0.021), blurred vision (p=0.001), feeling “in a fog” (p=0.014), difficulty remembering (p=0.004), and feeling emotional (p=0.041).
Youth and adolescent football players who sustain SRC on grass report higher post-concussive symptom severity and burden. Elucidating differential effects of SRC on grass versus turf is important, as competitive playing surface is a modifiable risk factor. 
Authors/Disclosures
Morgan M. Heinzelmann-Weisbaum, MD (Emory)
PRESENTER
Dr. Heinzelmann-Weisbaum has nothing to disclose.
Mathew Stokes, MD (University of Texas SW Medical School, Child Neurology) The institution of Dr. Stokes has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Global Medical Response.
Stephen Bunt (UT Southwestern Medical Center, Dallas) Stephen Bunt has nothing to disclose.
Nyaz Didehbani, PhD (UTSW) Dr. Didehbani has nothing to disclose.
No disclosure on file
Munro Cullum, PhD (Univ of Texas Southwestern Medical Center) The institution of Dr. Cullum has received research support from NIH. Dr. Cullum has received intellectual property interests from a discovery or technology relating to health care. Dr. Cullum has received personal compensation in the range of $10,000-$49,999 for serving as a Scientific Director with Texas Alzheimers Research and Care Consortium.