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Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives.
CONTEXTThe National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited.
OBJECTIVETo descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers.
PATIENTS OR OTHER PARTICIPANTSA total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions.
MAIN OUTCOME MEASURE(S)The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination.
RESULTSMost respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%, n = 473; Division III = 76.0%, n = 467) and determination of recovery (Division II = 65.0%, n = 194; Division III = 63.1%, n = 288) but not at baseline (Division II = 43.1%, n = 122; Division III = 41.0%, n = 176). Typically, when a postconcussion assessment was initiated, testing occurred daily until baseline values were achieved, and most respondents (80.6% [244/278]) reported using a graded exercise protocol before return to participation.
CONCLUSIONSWe found limited use of the multifaceted assessment battery at baseline but higher rates at both acute assessment and return-to-participation time points. A primary reason cited for not using test-battery components was a lack of staffing or funding for the assessments. We observed limited use of neuropsychologists to interpret neuropsychological testing. Otherwise, most respondents reported concussion-management protocols consistent with recommendations, including a high level of use of objective measures and incorporation of a progressive return-to-participation protocol.
Department of Kinesiology and Applied Physiology, University of Delaware, Newark.,
School of Health and Kinesiology, Georgia Southern University, Statesboro.
Department of Intercollegiate Athletics, Georgia Southern University, Statesboro.
Practice Guidelines as Topic
Practice Patterns, Physicians'
Return to Sport
Surveys and Questionnaires
Pub Type(s)Journal Article