Concussion-assessment and -management techniques used by athletic trainers

Area of Science:

• Sports Medicine
• Neurology
• Athletic Training

Background:

• Understanding current concussion assessment and management practices among athletic trainers (ATs) is crucial for improving patient care quality.
• Identifying strategies to enhance concussion care requires knowledge of existing diagnostic and return-to-participation protocols used by ATs.

Purpose of the Study:

• To evaluate the current concussion diagnostic practices employed by athletic trainers.
• To assess the return-to-participation protocols utilized by athletic trainers for athletes with concussions.

Main Methods:

• A cross-sectional study utilizing a web-based survey distributed to members of the National Athletic Trainers' Association.
• A total of 1053 certified ATs responded, providing data on concussion assessment and management strategies.
• Data collected included the annual number of concussions assessed and the tools used for diagnosis, management, and return-to-participation decisions.

Main Results:

• Athletic trainers reported assessing an average of 10.7 concussions annually.
• Clinical examination was the most common diagnostic method (70.6%), while less than half utilized standardized tools like the Standardized Assessment of Concussion (44.3%) or computerized neuropsychological testing (43.6%).
• Return-to-participation decisions were primarily based on clinical examination (73.4%), guidelines (67.7%), physician recommendations (62.7%), and player self-report (42.5%). Only 20.8% used all three recommended assessment domains.

Conclusions:

• A positive trend shows athletic trainers incorporating more objective clinical measures into concussion management.
• However, there is a noted decrease in the reported use of standard clinical examinations for concussion assessment.
• The findings emphasize the need for ATs to consistently utilize both objective assessment tools and standard clinical examinations for comprehensive concussion care.