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Neurocognitive Performance in Female American Football Players Differs From Their Male Counterparts
EP23848
Neurocognitive Performance in Female American Football Players Differs From Their Male Counterparts
Submitted on 26 Feb 2016

Donna M. Duffy, Kristen N. Schleich, Stephen M. Glass, Leah Washington, Jennifer L. Etnier, Scott E. Ross, & Christophe K. Rhea
University of North Carolina at Greensboro
Poster Views: 873
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Poster Abstract
Background: It has been suggested that females are more susceptible to concussions due to weaker and smaller neck muscles and as a result, females may experience a more severe concussion when acceleration and impacts are considered. Further, research indicates that females are more likely to report concussion symptoms and may take longer to recover than their male counterparts. If females do experience more severe concussions that may last longer, there is a need to establish independent female normative values in terms of neurocognitive performance before and after a concussive event.

Objective: This project examined a female-specific dataset for the neurocognitive Trail Making Test (TMT) and compared those values to already established men’s values.

Methods: Female participants (N=31, age=29.0±7.0 yrs, tackle football experience=2.7±1.7 yrs) from two Independent Women’s American Football League teams performed the neurocognitive TMT, which is administered as two separate tests. Test A (TMT_A) demonstrates how quickly the subject can connect each circle on the test by following the pattern A-M in alphabetical sequence with accuracy and precision. Test B (TMT_B) not only includes the accuracy and precision of TMT_A, but also includes switching between ordered sets from A to 1, B to 2, C to 3 and so on. The dependent variable is the time (sec) taken to complete each test. The TMT was administered during preseason testing. Normative TMT data from NFL players (N=654) in the Pellman et al. (2004) study were used as a male comparative sample. Cohen’s effect size (d) was calculated between our female football sample and the male NFL sample to determine the magnitude of differences between the datasets.

Results: A large effect size (d=1.62) was observed between our female football sample (M=17.20, SD=6.00) and the NFL male sample (M=21.40, SD=7.40) for TMT_A. Similarly, a large effect size (d=4.40) was observed between our female football sample (M=38.20, SD=14.20) and the NFL male sample (M=55.60, SD=17.10) for TMT_B.

Conclusion: Our female football sample showed better neurocognitive performance on the TMT relative to the NFL male sample. Our data suggests that sex-specific normative data may be needed to develop more appropriate return-to-play criteria in female football players.


Arnold, C. (2013). Concussions in women. Lancet Neurology, 13, 136-137.
Covassin, T., Elbin, R. J., Crutcher, B., & Burkhart, S. (2013). The management of sport-related concussion: considerations for male and female athletes. Translational Stroke Research, 4, 420-424.
Dick, R. W. (2009). Is there a gender difference in concussion incidence and outcomes. British Journal of Sports Medicine, 43(1), i46-i50.
Dvorak, J., McCrory, P., & Kirkendall, D. T. (2007). Head injuries in the female football player: incidence, mechanisms, risk factors and management. British Journal of Sports Medicine, 41(1), i44-i46.
Brown, D. A., Elsass, J. A., Miller, A. J., Reed, L. E., & Reneker, J. C. (2015). Differences in symptom reporting between males and females at baseline and after a sports-related concussion: A systematic review and meta-analysis. Sports Medicine, 45(7), 1027-1040
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