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Physicians' Management Practices and Perceived Health Risks When Postconcussion Symptoms Persist.

Sean C Rose1, Anastasia N Fischer2, Geoffrey L Heyer3

  • 1Division of Pediatric Neurology, Nationwide Children's Hospital, and Department of Neurology, The Ohio State University, Columbus, Ohio.

Sports Health
|January 7, 2016
PubMed
Summary

Physician approaches to persistent postconcussion symptoms vary, with differing views on health risks and management. This impacts patient care and access to specialized concussion clinics.

Keywords:
concussionmanagementmild traumatic brain injurypostconcussion syndromesurvey

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Area of Science:

  • Sports Medicine
  • Neurology
  • Public Health

Background:

  • Current concussion guidelines emphasize rest until symptom resolution due to risks like second impact syndrome.
  • The long-term health risks associated with persistent postconcussion symptoms are not well-defined.

Purpose of the Study:

  • To investigate physicians' perceptions of health risks and management strategies for patients with persistent postconcussion symptoms.
  • To understand variations in neuroimaging indications and referral patterns among physicians.

Main Methods:

  • A cross-sectional survey of 572 American College of Sports Medicine physician members.
  • Assessed perceived risks of advancing activity, neuroimaging indications, and referral patterns for persistent postconcussion symptoms.

Main Results:

  • Most physicians initially recommend physical and cognitive rest.
  • Perceived risks of advancing activity and second impact syndrome differ based on symptom duration (2 weeks vs. 3 months).
  • A significant portion of physicians recommend neuroimaging for symptoms persisting beyond one month, and access to multidisciplinary clinics varies.

Conclusions:

  • Physician management of persistent postconcussion symptoms is inconsistent regarding perceived risks and treatment strategies.
  • Variability in physician practices and access to specialized care highlights a need for standardized approaches.