Previous Exposure To And Perception Of Sports-related Concussion Among Collegiate Lacrosse Athletes In Japan

The majority of existing sports-related concussion (SRC) research among collegiate athletes has been conducted in the U.S., where qualified sports medicine personnel (SMP) is readily accessible. Lack of access to SMP may influence athletes’ SRC history, exposure to SRC education (SRC-E), and perception of SRC. PURPOSE: To investigate the current landscape of SRC history, SRC-E, and subjective perception about the understanding of SRC among collegiate lacrosse athletes in Japan where regular access to SMP is limited in many teams. METHODS: Men’s and women’s collegiate lacrosse athletes (n = 8,530) registered in the Japan Lacrosse Association membership directory for the 2021-2022 season received an online survey (August 16, 2021-September 12, 2021). Access to SMP (SMPYES, SMPNO), SRC history, previous experience receiving SRC-E, and response to “I have a clear picture or understanding of concussions” using a 5-scale Likert scale: strongly disagree, disagree, neither agree nor disagree, agree, strongly agree, were obtained for analysis. The Chi-square test was used to analyze categorical data. Statistical significance was set at p < 0.05 a priori. Odds ratio (OR) and 95% confidence interval (CI) were calculated, and Bonferroni correction was applied for post-hoc comparison, where appropriate. RESULTS: Survey response rate was 36.7% (n = 3,132), with 49.5% (n = 1,550) of respondents in SMPYES and 50.5% (n = 1,582) in SMPNO. 8.5% (n = 266) of athletes reported one or more histories of diagnosed SRC; no difference in SRC history was detected by access to SMP (χ2[1] = 0.89, p = 0.35). Athletes with and without SRC-E were 28.3% (n = 886) and 71.7% (n = 2,246), respectively. SRC-E and access to SMP were statistically associated, with a significant impact of SMPNO on no SRC-E (χ2[1] = 73.1, p < 0.001; OR = 2.01, 95%CI = [1.71, 2.36]). Subjective understanding of SRC differed by access to SMP (χ2[4] = 36.2, p < 0.001), where more SMPNO answered strongly disagree (p < 0.001) and more SMPYES answered agree (p < 0.001) to the statement, “I have a clear picture or understanding of concussions”. CONCLUSIONS: Access to SMP influenced athletes' exposure to SRC-E and their subjective perception of SRC understanding. A targeted educational effort that does not rely on SMP is warranted by the national federation for athletes without SMP access.