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J Athl Train. 2013 Nov-Dec;48(6):844-50. doi: 10.4085/1062-6050-48.6.04. Epub 2013 Oct 23.

Concussion-assessment and -management techniques used by athletic trainers.

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1
School of Kinesiology and Recreation, Illinois State University, Normal;

Abstract

CONTEXT:

Understanding concussion-assessmment and -management practices that athletic trainers (ATs) currently use will allow clinicians to identify potential strategies for enhancing the quality of care provided to patients.

OBJECTIVE:

To assess current clinical concussion diagnostic and return-to-participation practices among ATs.

DESIGN:

Cross-sectional study.

SETTING:

Web-based survey.

PATIENTS OR OTHER PARTICIPANTS:

A link to the survey was sent randomly to a convenience sample of 3222 members of the National Athletic Trainers' Association. A total of 1053 (32.7%) certified ATs (experience as an AT = 11.2 ± 9.1 years) responded to the survey.

INTERVENTION(S):

Prospective participants received electronic correspondence informing them of the purpose of the study and providing a link to the Web-based survey instrument. A reminder e-mail was sent approximately 6 weeks later, and the survey remained online for a total of 8 weeks.

MAIN OUTCOME MEASURE(S):

We collected information on the annual number of concussions assessed and tools employed to diagnose, manage, and safely return an athlete to participation. Descriptive statistics were computed for each variable.

RESULTS:

Participants reported observing 10.7 ± 11.0 concussions per year. Clinical examination (n = 743, 70.6%) was the most commonly reported means for evaluating and diagnosing concussion. Less than half of our respondents employed the Standardized Assessment of Concussion (n = 467, 44.3%), any variation of the Romberg test (n = 461, 43.8%), and computerized neuropsychological testing (n = 459, 43.6%). Clinical examination (n = 773, 73.4%), return-to-participation guidelines (n = 713, 67.7%), physician recommendation (n = 660, 62.7%), or player self-report (n = 447, 42.5%) contributed to the return-to-participation decisions of ATs. Only 20.8% (n = 219) of ATs reported using all 3 recommended domains of the concussion battery.

CONCLUSIONS:

Our study demonstrated a growth in the number of ATs incorporating objective clinical measures of concussion as a part of their concussion management. Conversely, fewer ATs reported using a standard clinical examination in their concussion assessment. These findings suggest ATs must continue to increase their use of both objective concussion assessment tools and the standard clinical examination.

PMID:
24143906
PMCID:
PMC3867097
DOI:
10.4085/1062-6050-48.6.04
[Indexed for MEDLINE]
Free PMC Article
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