Female adolescents demonstrate greater oculomotor and vestibular dysfunction than male adolescents following concussion

Phys Ther Sport. 2020 Mar:42:68-74. doi: 10.1016/j.ptsp.2020.01.001. Epub 2020 Jan 7.

Abstract

Objective: To examine differences between male and female adolescents on measures of balance, vestibular and oculomotor function within 3 weeks of concussion among a group of pediatric patients presenting to a sports medicine clinic.

Design: Medical record review.

Setting: Sports medicine clinic.

Participants: 197 female (median age = 15.2 years) and 381 male (median age = 14.6 years) pediatric patients seen for a concussion, evaluated 9.3 ± 5.2 (mean ± SD) days post-concussion.

Main outcome measures: Patients completed Balance Error Scoring System (BESS), tandem gait, gaze stability, and near point of convergence (NPC) tests.

Results: A higher proportion of female patients exhibited abnormal NPC (22% vs. 14%; p = 0.017), gaze stability (53% vs. 43%; p = 0.028), and tandem gait tests (20% vs. 13%; p = 0.026) compared to male patients. Multivariable analysis indicated an independent association between female sex and increased odds of abnormal NPC (adjusted odds ratio [aOR] = 1.79, 95% CI = 1.07-3.00), and tandem gait tests (aOR = 1.96, 95% CI = 1.12-3.41) following concussion.

Conclusions: Our results indicate that within the first three weeks of a concussion, female pediatric patients demonstrated increased odds of exhibiting abnormal near point of convergence, and tandem gait test performance compared to male patients.

Keywords: Adolescence; Mild traumatic brain injury; Pediatric; Postural balance; Sex differences; Sports.

MeSH terms

  • Adolescent
  • Athletic Injuries / complications
  • Athletic Injuries / physiopathology*
  • Brain Concussion / complications
  • Brain Concussion / physiopathology*
  • Eye Movements / physiology*
  • Female
  • Gait / physiology
  • Humans
  • Male
  • Oculomotor Muscles / physiopathology*
  • Postural Balance / physiology*
  • Vestibular Diseases / etiology
  • Vestibular Diseases / physiopathology*
  • Vestibular Function Tests
  • Vestibule, Labyrinth / physiopathology*