Time Of Season And Concussion Incidence For Sex-comparable Middle School Sports

Prior reports show girls to have a higher concussion rate than boys in sex-comparable sports. However, it remains unknown if sex differences in concussion incidence vary by time of season (TOS). PURPOSE: To characterize concussion incidence among boys’ and girls’ participating in sex-comparable middle school sports by TOS. METHODS: Certified athletic trainers collected concussion data for all middle school-sponsored sports events in a public-school division in Virginia over six school years (2015-16 to 2021-22). The 9-week sports season was divided into 3-week intervals (i.e., beginning, middle, and end). Concussion incidence per 100 player-seasons (IR) with 95% Confidence intervals (CI) were calculated for sex-comparable sports (baseball/softball, basketball, soccer, track). Rate ratios (RR) with 95% CIs were used to compare concussion incidence between part of the season. RRs with 95% CIs excluding 1.0 were considered statistically significant. RESULTS: 89 concussions were reported with an overall incidence rate of 0.78 per 100 player-seasons (95% CI:0.62-0.94) (Table 1). Girls had a two-fold higher IR (RRG/B = 2.27, 95% CI: 1.44-3.57) than boys across all times of season. Overall, the most common TOS for concussions was the middle (IR = 0.33), followed by the end (IR = 0.28) and the beginning (IR = 0.17). Girls increased risk compared to boys was most pronounced at the end of the season (IRRG/B = 2.53, 95% CI: 1.79-3.57) while consistent during the beginning (RRG/B = 2.14, 95% CI: 1.37-3.36) and middle (RRG/B = 2.14, 95% CI: 1.56-2.94) times of season. CONCLUSION: MS girls had a significantly higher rate of concussion compared to boys, with the most pronounced difference at the end of the season. These findings highlight the importance of concussion prevention and management efforts in girl’s middle school sports. Further research is needed to identify specific concussion risk reduction strategies that consider TOS for MS girls sports.