An Inside Look at Para Sport Concussion Care: Para Sport Health Care Providers' Perspectives

Para sport athletes experience concussions at a similar rate to athletes without disabilities; however, published concussion tools have limited applicability to diverse athlete populations.

To understand health care provider (HCP) concussion management across different para sports and athlete classifications to identify facilitators and barriers influencing the delivery of concussion care.

Cross-sectional study.

Online survey and virtual interviews.

Para sport HCPs completed online surveys (n = 21) and voluntary follow-up interviews (n = 11).

Researchers designed a survey from an established line of health care evaluation surveys and distributed it via chain-referral sampling following expert review (n = 3) and pilot testing (n = 4). We conducted follow-up interviews via Google Meet using automatic transcription technology and reviewed for accuracy. We used phenomenology to analyze the qualitative data with multianalyst triangulation and peer review as credibility strategies.

Health care providers most often used the Sport Concussion Assessment Tool 6 (85.7%) to guide examinations, the modified Balance Error Scoring System (66.7%) for balance testing, and the Vestibular/Ocular-Motor Screening (81.0%) for vestibular ocular-motor testing. Health care providers noted 3 themes: (1) the importance of developing purposefully flexible classification- and para sport-specific frameworks to promote individualized concussion care while (2) building personal HCP-athlete relationships to understand individual needs and improve concussion diagnostics and emphasizing (3) a multidisciplinary, team-based approach to care. Health care providers emphasized these themes as critical for successful management across para sports to overcome limited education and resource allocation available to often volunteer-based HCPs.

Para sport HCPs used current concussion assessment tools but reported a lack of effective adaptive guidelines exemplified by variable athlete-specific modifications for concussion care. Our findings emphasize the need to develop flexible frameworks for para sport concussion management while emphasizing a multidisciplinary, team-based approach to care and HCP-athlete relationships to implement effective para sport concussion care.