Utilisation of New Zealand Rugby's concussion management pathway: A mixed methods investigation

Area of Science:

• Sports Medicine
• Public Health
• Injury Prevention

Background:

• Concussion management in community sports faces implementation challenges.
• Effective translation of concussion guidelines is crucial for player safety.
• New Zealand Rugby's Concussion Management Pathway (CMP) aims to standardize care.

Purpose of the Study:

• To assess player utilization and compliance with the New Zealand Rugby Concussion Management Pathway (CMP).
• To identify facilitators and barriers to concussion guideline implementation in community rugby.
• To inform strategies for improving concussion care in sports.

Main Methods:

• Pragmatic, mixed-methods study combining concussion injury surveillance and healthcare pathway mapping.
• Analysis of player healthcare touchpoints within the CMP.
• Semi-structured interviews with stakeholders to explore experiences and perceptions.

Main Results:

• Only 28% of players followed the ideal CMP, with 27 different healthcare pathways identified.
• 70% of suspected concussions were logged in the CMP app, and 89% of these had baseline assessments.
• 64% of players obtained medical clearance before returning to contact training.
• 'Belief in the value of the pathway,' clear communication, and strong relationships were key facilitators.
• Baseline testing emerged as a potential precursor to overall CMP compliance.

Conclusions:

• Player compliance with concussion management pathways in community rugby can be enhanced.
• Strategies supporting identified facilitators, such as improving concussion knowledge and communication, are recommended.
• Optimizing access to general practitioners and leveraging technology like the CMP app can improve adherence.