Concussion Management Practices for Youth Who Are Slow to Recover: A Survey of Canadian Rehabilitation Clinicians

The objective of this study was to estimate the scope of concussion management practices for youth used by Canadian rehabilitation clinicians. A secondary objective was to determine the use of aerobic exercise as a management strategy. Members of the Canadian Association of Occupational Therapists, Canadian Athletic Therapists Association, and Canadian Physiotherapy Association were invited to participate in an online cross-sectional survey. Two clinical vignettes were provided with a brief history. The respondents were asked about the type of treatments they would provide (e.g., manual therapy, education, aerobic exercise, return-to-learn or return-to-play protocol, goal setting). The survey was completed by 555 clinicians. The top five treatment options were education, sleep recommendations, goal setting, energy management, and manual therapy. Just more than one-third of the clinicians prescribed aerobic exercise. Having a high caseload of patients with concussion (75%-100%) was a significant predictor of prescribing aerobic exercise. A wide variety of treatment options were selected, although the most common were education, sleep recommendations, energy management, and goal setting. Few clinicians used aerobic exercise as part of their concussion management strategy.