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Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives.

Abstract

CONTEXT

The 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.

OBJECTIVE

To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers.

DESIGN

Cross-sectional study.

SETTING

Web-based questionnaire.

PATIENTS OR OTHER PARTICIPANTS

A 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.

RESULTS

Most 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.

CONCLUSIONS

We 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.

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  • Authors+Show Affiliations

    ,

    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.

    Source

    Journal of athletic training 50:8 2015 Aug pg 879-88

    MeSH

    Athletic Injuries
    Brain Concussion
    Cross-Sectional Studies
    Female
    Humans
    Male
    Neuropsychological Tests
    Practice Guidelines as Topic
    Practice Patterns, Physicians'
    Return to Sport
    Sports
    Sports Medicine
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    26196701