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CARE Consortium: Influence of self-reported fatigue and gender on concussion baseline scores

Researchers find student-athletes who indicate higher fatigue levels report more total symptoms during baseline tests

A litany of factors — testing environment, testing group size and mental health history, plus others — can affect the results of baseline concussion tests. But what role does fatigue play, if any? Answering that could give clinicians guidance on when they should schedule baseline tests so that results aren’t skewed by the effects of preseason practice or other strenuous activities. Patricia Combs, a postdoctoral researcher at the University of North Carolina School of Medicine, led a team that published a study on the subject in the Orthopaedic Journal of Sports Medicine. The group relied on data from the ongoing NCAA-Department of Defense Concussion Assessment, Research and Education Consortium study.

What did the study find?

Both male and female athletes who reported higher fatigue levels reported more total symptoms such as headache, balance problems and trouble falling asleep, and indicated higher symptom severity at baseline in a range of tests.

What are the implications?

Fatigue may be associated with a decrease in balance and neurocognitive performance, meaning that baseline tests taken when athletes are experiencing fatigue may not provide a valid representation of their true baseline. “It suggests that levels of reported exhaustion can influence concussion assessment scores meant to represent a healthy baseline and will likely interfere with post-injury assessment scores,” the paper noted.

What’s next?

While the study outlined that fatigue may have an impact on baseline performance, it did not suggest when or where to conduct baseline tests. “Future research should evaluate ideal times and environments for student-athletes to complete baseline concussion assessments to elicit the most valid and accurate baseline results free from fatigue,” the authors wrote.