Under-reporting of sport-related concussions by adolescent athletes: a systematic review

ABSTRACT

The objective of this systematic review was to examine and synthesize the current literature on sport-related concussion under-reporting in adolescent athletes. In addition, the review addresses perceived barriers for reporting, and identifies sex or gender differences in reporting behaviours. Eight databases were searched for articles that explore sport-related concussion under-reporting in adolescent athlete populations (13–18 years old). Articles were screened at the title/abstract level followed by full-text review by independent reviewers. In total, 5390 articles were screened for inclusion, and 26 articles were included in the review. All studies found evidence for athletes failing to disclose concussion symptoms. Barriers for disclosure included athletes’ desires to remain in games and interpersonal dynamics among the athlete, teammates and coaches. Both male and female athletes were found to under-report symptoms, with limited evidence suggesting male athletes under-report more frequently. Concussion education does not appear to be an effective deterrent for under-reporting, and prior concussion knowledge does not appear to predict sustained improvements in under-reporting behaviours. Future work needs to address more context and sport-specific education initiatives to target athletes who may be at high-risk for under-reporting.

KEYWORDS:

• Concussion
• reporting
• symptom disclosure
• youth athletes
• education

Acknowledgements

The authors wish to thank Erica Nekolaichuk for her assistance with the search strategy.

Disclosure statement

No potential conflict of interest was reported by the author(s).