Exploring differences in concussion prevalence and symptoms among elite contact sports athletes and the general public

Abstract

There is a long-standing debate about definitions and diagnosis of concussions, resulting in under-recognition and underestimation of concussion rates and variability in estimated prevalence. Understanding the level of concussion knowledge and possible symptom manifestations among athletes compared to the general public is important. The objective of this study was to examine whether Icelandic athletes were more aware of concussions than the public, before and after presenting a medically accepted concussion definition. Furthermore, the aim was to examine the different prevalence of concussions and severity and pattern of concussion symptoms between elite athletes and the public, and differences in factor structures of reported post-concussion symptoms between the groups. The study included 700 participants (44.3% male), with a mean age of 30.85 (SD = 7.12). Participants included elite contact sports athletes and non-athletes, matched on age, gender, and education, who completed the SCAT-5 self-report to assess post-concussion symptoms.Results indicated that post-definition, elite athletes reported a significantly higher incidence of concussions compared to the general public (70.0% vs. 60.3%). Elite athletes were more likely to positively change their concussion status post-definition. Despite higher concussion prevalence among elite athletes, the general public exhibited more severe symptoms across nearly all post-concussion aspects. Factor analysis revealed four distinct symptom clusters for elite athletes: emotional, somatic, cognitive, and migraine-related symptoms. Non-athletes´ symptoms grouped into three factors: physical and sensory symptoms, emotional and cognitive symptoms, and head and neck pain.The study highlights the need for better concussion education and customized management strategies to address the wide-ranging effects of concussions more effectively. It also highlighted the notable differences in concussion reporting and symptom severity between elite athletes and the general public.