Impact of Playing Surface on Concussion Symptoms in Young American Football Players. (4th January 2022)

• Record Type: Journal Article
• Authors: Heinzelmann, Morgan Michelle; Stokes, Mathew; Bunt, Stephen; Didehbani, Nyaz; Miller, Shane; Cullum, Munro
• Is Part Of: Neurology. Volume 98:Number 1(2022)Supplement 1
• Page Start: S12
• Page End: S12
• Publication Date: 2022-01-04
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/01.wnl.0000801844.07749.49
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To identify differences in symptoms following sports-related concussion (SRC) on natural grass vs artificial turf in youth and adolescent football players. Background: 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. Design/Methods: 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. Results: 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). Conclusions: 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 vs turf is important, as competitive playing surface is a modifiable risk factor.