Sex and Sport-Specific Differences on Baseline Concussion Balance Test Performance in Division-I Collegiate Athletes

Objective: This study aimed to identify factors affecting baseline performance in collegiate athletes using the Concussion Balance Test (COBALT^©). Design: Cross-sectional study design. Setting: Sports medicine research laboratory. Participants: NCAA Division-I collegiate athletes (n 5 127; 77 male, 50 female). Independent Variables: Sport, sex, history of concussion, and time since last concussion. Main Outcome Measures: Postural sway and the number of errors across 4 COBALT conditions. Results: Significant differences in postural sway and errors were observed based on sex. Female athletes demonstrated higher postural sway (0.34 degrees/s; P, 0.001) and more errors (1.69 errors; P, 0.001) on Condition 7 than male athletes. Concussion history and time since last concussion had no significant effect on postural sway or errors (P . 0.05). Differences between sports were identified, with cheerleaders demonstrating more errors than football players (Conditions 3, 7, 8; errors; P, 0.05) and soccer players (Conditions 3, 7, 8; P, 0.05), and soccer athletes demonstrating more errors than football players on Condition 7 (1.47 errors; P, 0.05). Conclusions: Our findings suggest that the COBALT is a useful tool for measuring balance performance, offering insights into baseline performance that may influence concussion management. Differences in performance based on sex and sport, but not concussion history, were observed, highlighting the importance of considering individual factors when interpreting baseline test results. Clinical Relevance: Based on the data presented and results of this investigation, clinicians should consider an athlete’s sex, sport, and concussion history when interpreting COBALT performance at baseline. Further research is needed to explore the impact of these factors on postinjury performance.