Concussion research largely excludes female athletes, study finds

There's growing consensus on the danger of sport-related concussion - and how to treat athletes after head injuries. But the research at the heart of those recommendations has a fatal flaw, a new study suggests: It relies almost exclusively on male athletes.

In a review in the British Journal of Sports Medicine, a national team of medical and concussion experts looked at 171 concussion studies cited by the three most influential consensus and position statements on sport-related concussion. These documents update professionals on how to treat athletes with concussions, providing important protocols for clinicians and setting the agenda for future research.

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Although the statements define the standard of care, the study suggests, they are based on data that largely excludes female athletes.

Participants in the underlying studies were 80.1% male. Among the studies, 40.3% didn't look at female athletes at all; only 25% of them had roughly equal male and female participation.

Researchers said there could be several reasons for the disparity such as women's historic exclusion from sports and professional sports organizations with no female counterpart. Women's sports are underrepresented among groups that sponsor concussion research, they write.

Bias in the sciences could have an effect, too: women are still underrepresented in both university faculties and scientific research.

Because of the research gap, it isn't yet clear whether females respond to concussions differently than males. Both sex and gender can cause medical conditions to develop - and be experienced, reported and treated - differently.

But the researchers say there are ways to narrow the gap, and suggest the public can help.

In addition to supporting increased public health spending on research that includes female athletes, people can simply show up for women's sports, writes Christopher D'Lauro, a professor of cognitive neuroscience at the U.S. Air Force Academy and a co-author of the paper.

"Go to women's games, watch them on TV, and purchase their merchandise," he writes. "Greater revenue for women's sports means a greater likelihood of having robust in-place medical staff, better training facilities, and better television production values" - boosting not only the number of fans but also concussion data and effective treatment.

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