Baseline Performance on Concussion Assessments of Athletes Who Are Deaf or Hard of Hearing.

Abstract

Context In the United States, more than 71 000 college students, many of whom participate in athletic programs, are deaf or hard of hearing (D/HoH). Although recent concussion consensus statements have recommended different management for special populations, critical knowledge gaps remain regarding baseline concussion performance in athletes who are D/HoH. Objective To compare baseline concussion assessments between athletes who are D/HoH and athletes who are hearing. Design Cross-sectional study. Setting Collegiate athletic department. Patients or other participants A total of 128 National Collegiate Athletic Association Division III athletes including 64 athletes who are D/HoH (42 who are deaf, 22 who are hard of hearing; age = 21.64 ± 3.23 years, height = 1.70 ± 0.10 m, mass = 80.83 ± 25.24 kg) and 64 athletes who are hearing (age = 19.73 ± 1.13 years, height = 1.76 ± 0.10 m, mass = 78.55 ± 16.95 kg) matched by sex and sport-contact classification. Main outcome measures Participants completed a comprehensive battery of baseline concussion assessments, including symptom inventories (Sport Concussion Assessment Tool 6 symptom evaluation and Brief Symptom Inventory-18), virtual reality-based smooth pursuits, oculomotor function (Vestibular/Ocular Motor Screening), postural control (modified Balance Error Scoring System), instrumented tandem gait, and neurocognitive testing (Immediate Post-Concussion Assessment and Cognitive Testing). Results No differences were found for Sport Concussion Assessment Tool 6 symptom severity ( z = -1.41, P = .16) or total number of symptoms ( z = -1.62, P = .11), but athletes who are D/HoH had a higher Brief Symptom Inventory-18 Global Severity Index ( z = -2.37, P = .02) compared with athletes who are hearing. Athletes who are D/HoH demonstrated better oculomotor tracking (eg, higher velocity gain and lower saccade percentage, P z = 2.57, P = .01) compared with athletes who are hearing. Additionally, athletes who are D/HoH demonstrated poorer performance in postural control (more modified Balance Error Scoring System errors, z = -5.24, P z = 3.65, P P Conclusions Athletes who are D/HoH exhibited distinct performance profiles across multiple baseline concussion domains, likely influenced by sensory adaptations, vestibular differences, and language-related factors. Clinicians should interpret assessment outcomes while considering these unique biopsychosocial characteristics to ensure accurate concussion management for D/HoH populations.