Comparing Low Energy Availability Risk Between Female Adolescents With And Without Concussion

PURPOSE: After concussion an energy crisis occurs, resulting in metabolic disruption and energy deficiency. Physical activity (PA; i.e., energy expenditure) is recommended for concussion recovery. Low energy availability (LEA) may impair physiological function and recovery, or contribute to concussion symptoms. Our purposes were to 1) investigate LEA risk among female adolescents with/without concussion and 2) examine the relationship between LEA risk and concussion symptom severity. METHODS: Females (ages 13-18 years, post-menarche) within 21 days of concussion and uninjured controls completed the Low Energy Availability in Females questionnaire (LEAF-Q) evaluating gastrointestinal symptoms, menstrual function, and injury frequency (score range = 0-25, scores≥8 indicate LEA risk). The concussion group rated symptoms using the Post-Concussion Symptom Inventory (PCSI; score range 0-120, higher scores indicate more severe symptoms). We used t-tests and calculated effect size to examine LEAF-Q between-group differences, and linear regression for a multivariable comparison. For the concussion group, we examined the correlation (Pearson r) between LEAF-Q and PCSI scores. RESULTS: We enrolled 109 participants (control: n = 82, age = 15.8 ± 1.4 years; concussion: n = 27, age = 15.8 ± 1.3 years, 12.4 ± 4.2 days post-concussion). The concussion group reported higher LEAF-Q scores than controls (Fig A). After adjusting for prior concussion, age, and BMI, LEAF-Q scores were higher for the concussion group compared to controls (β = 2.53; 95% confidence interval = 0.89-4.16; p = 0.003). There was no correlation between LEAF-Q and PCSI scores for the concussion group (Fig B). CONCLUSIONS: Female adolescents after concussion may have higher LEA risk than controls. EA may be an important consideration for post-concussion PA recommendations. The lack of correlation between LEAF-Q and PCSI scores indicates that LEA may occur independent of concussion symptoms. Supported by: Eunice Kennedy Shriver National Institute of Child Health & Human Development (R01HD108133), Tai Foundation