Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies

Finch, Caroline F.; McCrory, Paul; Ewing, Michael Thomas; Sullivan, S John

doi:10.1136/bjsports-2012-091796

Cited by 52 publications

(47 citation statements)

References 38 publications

(42 reference statements)

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“…Finch et al suggest that there is a need to improve dissemination of the current guidelines. 43 For the chiropractic profession, education begins at the predoctoral level and continues through the continuing education requirements for licensed doctors. The brief predoctoral coverage of this topic may need to become more comprehensive.…”

Section: Discussionmentioning

confidence: 99%

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Taylor

Ponce²,

Dyess

2017

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to assess the self-reported knowledge of concussion recognition and treatment with first-contact family medical and chiropractic practitioners by means of a pilot study of the need, construct validity, and feasibility for further investigation of mild traumatic brain injury (MTBI) knowledge base. Methods: Two hundred forty-eight practicing chiropractic and 120 medical physicians in the south and northeastern sections of the United States were contacted by e-mail, telephone, and postal mail to answer an 18-item survey on knowledge, diagnosis, and common practice with respect to traumatic brain injury patients. Descriptive analysis was used to assess common trends. Results: Twenty-three chiropractic and 11 medical primary care practitioners returned completed surveys, making this a low-power pilot study. The majority claimed confidence in diagnosis of MTBI, but a lack of knowledge of many of the assessment tools and the international guidelines. Chiropractic and medical clinicians revealed similar competencies and differing deficiencies. Both groups admitted infrequent diagnosis of MTBI in practice. There was recognition of major TBI signs, but lack of recognition or inquiry for subtle MTBI signs. Conclusions: There is a need and feasibility for further study of the knowledge transfer to the chiropractic physician with a larger population. These findings correlate with similar medical practitioner studies, and may also support previous findings of underreporting of the prevalence of MTBI. The survey instrument appears to provide valid data on knowledge of MTBIs, with some modifications. (J Chiropr Med 2017;16:19-30)

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Section: Discussionmentioning

confidence: 99%

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Taylor

Ponce²,

Dyess

2017

Journal of Chiropractic Medicine

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“…Trends such as these suggest that the current sideline treatment and return-to-play guideline revisions are not being reliably implemented in amateur and community sport. Finch and colleagues 47 suggest that this may be due to the typically clinical perspective of concussion management, as well as the lack of consideration for the broader contextual variables that may impact upon athlete's attitude towards the value and relevance of injury prevention information.…”

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confidence: 99%

“…Despite the new information that these guidelines present, the extent to which these regulation updates are disseminated and implemented remains scarce, especially in amateur and community teams 46 . The majority of these guidelines and guideline changes are publicised through peerreviewed journals, mostly aimed at medical professionals; however, this information does not appear to be being consistently implemented in community sport 47 . In a sample of Australian Rugby players, Hollis et al 46 found that 78% of players with experiencing a suspected concussion failed to receive return-to-play advice and those how did receive the correct advice failed to comply with regulations anyway.…”

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confidence: 99%

“…In a sample of Australian Rugby players, Hollis et al 46 found that 78% of players with experiencing a suspected concussion failed to receive return-to-play advice and those how did receive the correct advice failed to comply with regulations anyway. Furthermore, 23% of community Rugby coaches were either unaware or unsure of the Australian Rugby Union's prescribed concussion treatment guidelines 47 . Trends such as these suggest that the current sideline treatment and return-to-play guideline revisions are not being reliably implemented in amateur and community sport.…”

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confidence: 99%

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Risk factors to sport-related concussion for junior athletes

Clacy¹,

Sharman²,

Lovell³

2013

OA Sports Medicine

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IntroductionAs more than just an enjoyable activity, team sport offers a range of invaluable benefits to players and has the potential to provide personal, physical and social growth. Despite the many benefits of team sport participation, these benefits do not come without some cost. Although there are strict rules and guidelines in all contact sports, the risk of injuries such as concussion are impossible to prevent completely. Sport-related concussion is a growing concern in contact sport; however, the underlying risk factors and epidemiology of sport-related concussion in junior athletes is not well understood. The notable cognitive, hormonal and neurophysiological changes occurring during development throughout late childhood and adolescence potentially places paediatric athletes at greater risk of sustaining and experiencing enduring effects of brain injury. The aim of this review is to discuss the risk factors to sport-related concussion for junior athletes. Discussion Although research is inconsistent, there have been some suggestions of specific individual variables functioning as possible antecedents that increase risk of sustaining a concussion, such as prenatal testosterone exposure, executive function and sensation seeking behaviour. The growing body of inconclusive and speculative studies on this issue highlights the need for more research into

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“…For example, a recent study examining the return-to-play recommendations of medical officers in the English Football Association (FA) found that a majority of teams did not follow the recommendations of the Zurich Consensus guidelines (Price, Malliaras, and Hudson 2012). It has been assumed that lack of awareness is the major reason why concussion management guidelines are not enforced (around onequarter of FA medical officers had not heard of the Zurich guidelines), leading some to propose wider dissemination strategies in the hope this will promote greater uptake (Finch et al 2013). …”

Section: Introductionmentioning

confidence: 99%

Dazed and Confused: Sports Medicine, Conflicts of Interest, and Concussion Management

Partridge

2013

Bioethical Inquiry

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Professional sports with high rates of concussion have become increasingly concerned about the long-term effects of multiple head injuries. In this context, return-to-play decisions about concussion generate considerable ethical tensions for sports physicians.Team doctors clearly have an obligation to the welfare of their patient (the injured athlete) but they also have an obligation to their employer (the team) whose primary interest is typically success through winning. At times, a team's interest in winning may not accord with the welfare of an injured player particularly when it comes to decisions about returning to play after injury. Australia's two most popular professional football codes -rugby league and Australian Rules football -have adopted guidelines that prohibit concussed players from continuing to play on the same day. I suggest that conflicts of interest between doctors-patients-teams may present a substantial obstacle to the proper adherence of concussion guidelines. Concussion management guidelines implemented by a sport's governing body do not necessarily remove or resolve conflicts of interest in the doctorpatient-team triad. The instigation of a concussion exclusion rule appears to add a fourth party to this triad (the NRL or AFL). In some instances, when conflicts of interest among stakeholders are ignored or insufficiently managed, they may facilitate attempts at circumventing concussion management guidelines to the detriment of player welfare.

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Concussion guidelines need to move from only expert content to also include implementation and dissemination strategies

Cited by 52 publications

References 38 publications

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Risk factors to sport-related concussion for junior athletes

Dazed and Confused: Sports Medicine, Conflicts of Interest, and Concussion Management

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