@article{ref1,
title="Impact of playing surface on concussion symptoms in young American football players",
journal="Neurology",
year="2022",
author="Heinzelmann, Morgan Michelle and Stokes, Mathew and Bunt, Stephen and Didehbani, Nyaz and Miller, Shane and Cullum, Munro",
volume="98",
number="Suppl 1",
pages="S12-S12",
abstract="OBJECTIVE: To identify differences in symptoms following sports-related concussion (SRC) on natural grass vs artificial turf in youth and adolescent football players. <br><br>BACKGROUND: There is continued interest in reducing risk of SRC in football, with playing surface being one potentially modifiable factor. It is estimated that 15-30% of concussions result from helmet-to-ground contact, and some studies have suggested a higher incidence of SRC on grass in competitive contact sports compared to turf. To our knowledge, our study is the first to investigate reported post-concussive symptoms after SRC as they relate to playing surface. DESIGN/METHODS: Data were prospectively collected from the North Texas Concussion Registry (ConTex), a longitudinal multi-institutional concussion database. We selected male football players between the ages of 10 and 24 who sustained a helmet-to-ground SRC (GCS 13-15) on either grass or turf. Pre-injury information and post-concussive symptoms (Graded Symptom Checklist from the SCAT-5) were collected at an initial in-person visit within 2 weeks of injury and via electronic follow up at 3 months. <br><br>RESULTS: Fifty-eight participants were included (grass = 32, turf = 26), and groups were similar in age (p = 0.089), time since injury (p = 0.500), history of headache (χ2 = 0.167), and prior history of concussion (χ2 = 0.868). Athletes who sustained SRC on grass reported significantly higher scores on the Graded Symptom Checklist (p = 0.018, mean 26.0 vs 11.4) and higher numbers of distinct symptoms (p = 0.013, mean 10.2 vs 5.5) compared to those who sustained SRC on turf. Symptoms that were rated significantly higher after SRC on grass included headache (p = 0.010), phonophobia (p = 0.014), dizziness (p = 0.001), fatigue (p = 0.021), blurred vision (p = 0.001), feeling &quot;in a fog&quot; (p = 0.014), difficulty remembering (p = 0.004), and feeling emotional (p = 0.041). <br><br>CONCLUSIONS: Youth and adolescent football players who sustain SRC on grass report higher post-concussive symptom severity and burden. Elucidating differential effects of SRC on grass vs turf is important, as competitive playing surface is a modifiable risk factor.<p /> <p>Language: en</p>",
language="en",
issn="0028-3878",
doi="10.1212/01.wnl.0000801844.07749.49",
url="http://dx.doi.org/10.1212/01.wnl.0000801844.07749.49"
}