Moving concussion care to the next level: The emergence and role of concussion clinics in the UK

Ahmed, Osman Hassan; Loosemore, Mike; Hornby, K; Kumar, Bhavesh; Sylvester, Richard; Makalanda, Hegoda Levansri Dilrukshan; Rogers, Tim; Edwards, David J.; Medici, Akbar de

doi:10.1016/bs.pbr.2017.06.014

Cited by 8 publications

(7 citation statements)

References 52 publications

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“…A multimodal clinical assessment and rehabilitation approach, ideally by a multidisciplinary team, can provide a comprehensive and streamlined service to players, especially for those with prolonged symptoms. 6,43,60 Local implementers should bear in mind that the nature of the concussion and the individuality of players, as well as general concussion attitudes and knowledge of stakeholders, may influence the CMP flow. Future work should consider strategies facilitating the provision of information and guidance, communication between stakeholders, and additional multi-level concussion education initiatives within local contexts.…”

Section: Discussionmentioning

confidence: 99%

“…Dedicated primary care concussion clinics were specifically identified as important facilitators of the CMP. Previous research has similarly suggested the important role of such clinics in offering multidisciplinary concussion management, 43 potentially decreasing primary care resource utilization and facilitating more consistent concussion care. 44 As is the case with injury prevention, 33 injury management programs will only be successful if they are adopted by the local context.…”

Section: Importance Of Contextmentioning

confidence: 99%

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Managing concussion in the real world: Stakeholder perspectives of New Zealand Rugby's concussion management pathway

Salmon,

Walters,

Brown

et al. 2023

International Journal of Sports Science & Coaching

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The potential adverse consequences associated with poor concussion management highlights the need to improve the translation of concussion guidelines into consistent use in real-world sport settings. To facilitate this process, New Zealand Rugby developed a community concussion management pathway to support concussion recognition, diagnosis, and management. This study adopted a pragmatic, descriptive qualitative approach to explore key stakeholders’ perceptions of the concussion management pathway, with the aim to inform policy and practice. Interviews were conducted with 123 participants, including players, parents, coaches, healthcare professionals, and school and provincial union representatives. The framework method was used to analyze data. Themes were organized according to the principles of realist process evaluation that considers contextual factors and mechanisms influencing a program's operation to produce specific outcomes. Contextual factors influencing the concussion management pathway's implementation included governing bodies’ support, existing local resources, general concussion attitudes, or concussion severity. The optimal functioning of the concussion management pathway ( mechanism) was influenced by (i) pathway resources, (ii) roles and relationships, (iii) buy-in and support towards the concussion management pathway, and (iv) diligence and communication. Outcomes identified included (i) hitting the target (optimally managed and enhanced awareness) or (ii) missing the mark (dissatisfaction or management gaps). Overall, participants found the concussion management pathway valuable. However, the acceptability of certain policy-related aspects and the underlying attitudes associated with these perceptions, are some areas requiring further investigation and support. Tailoring programs according to end-users’ perceptions is crucial in developing context-sensitive interventions appropriate for a specific setting. These findings may act as a foundation for investigations of concussion management in other settings.

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Section: Discussionmentioning

confidence: 99%

Section: Importance Of Contextmentioning

confidence: 99%

Managing concussion in the real world: Stakeholder perspectives of New Zealand Rugby's concussion management pathway

Salmon,

Walters,

Brown

et al. 2023

International Journal of Sports Science & Coaching

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“…3 However, approximately 10% of individuals with concussion might experience cognitive and/or physical impairments beyond 1 month, thus facing a significant burden in their school-related or work-related activities. 4,5 Despite this, only few countries worldwide, including the United States, 6 the United Kingdom, 7 Canada, 8 New Zealand, 9 and Australia, 10 can boast broad structured integrated policy-driven programs at a granular level to identify and monitor individuals affected by concussion. Nonetheless, concussion management and compliance with return-to-play (RTP) guidelines remain suboptimal among both athletes and coaches, even within these countries.…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, only few countries worldwide, including the United States, 6 the United Kingdom, 7 Canada, 8 New Zealand, 9 and Australia, 10 can boast broad structured integrated policy-driven programs at a granular level to identify and monitor individuals affected by concussion. Nonetheless, concussion management and compliance with return-to-play (RTP) guidelines remain suboptimal among both athletes and coaches, even within these countries.…”

Section: Introductionmentioning

confidence: 99%

Concussion Knowledge and Self-Reported Behaviors in Youth Rugby Players and Their Coaches: A Population-Wide Cross-Sectional Survey

Bazo

Arpone

Baioccato

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To investigate concussion knowledge and self-reported behaviors in Italian youth rugby players and their coaches. To investigate predictors of lower concussion knowledge and association between athletes' self-reported knowledge and behavior. Design: Cross-sectional, population-wide, survey study. Setting: All rugby clubs (n 5 52) of the Veneto region (Italy). Participants: Players and coaches of all under 15, 17 and 19 teams. Overall, 1719 athlete surveys (92.2% male; response rate, 71.1%) and 235 coach surveys (93.6% male; response rate, 93.2%) were eligible for analysis. Intervention: Surveys circulated from September 20 to December 13, 2021. Main Outcome Measures: Knowledge scores were reported as a percentage of correct answers. Descriptive statistics were reported for all answers. The primary outcomes were concussion knowledge and self-reported behaviors. The secondary outcomes were the association between knowledge and participant individual factors and self-reported behaviors. Results: Median knowledge score for athletes was 55% (IQR: 44-67) and for coaches was 60% (IQR: 52.5-69). Only 33.3% of athletes and 40% of coaches were aware of an increased risk of a second concussion after sustaining one. Athletes who had never heard of the word concussion (effect: 29.31; SE: 1.35, 95% CI: 212.0 to 26.7; P , 0.0001) and coaches with longer coaching experience (effect: 24.35; SE: 2.0, 95% CI: 28.29 to 20.41; P , 0.03) reported lower knowledge scores. There was no statistical association between knowledge scores and athlete self-reported behavior. Conclusion: Athletes and coaches had a similar level of concussion knowledge. Knowledge score of athletes did not predict self-reported behaviors. Although enhanced concussion education should be undertaken, interventions to ensure appropriate concussion reporting behaviors are also required.

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“…Concussion advice in the ED is minimal compared with Return to Play guidance for athletes 7. This may partly be due to time pressure and partly due to prioritisation perspective, as the priority for ED is to rule out life-threatening events 13…”

Section: Introductionmentioning

confidence: 99%

Concussion assessment in the emergency department: a preliminary study for a quality improvement project

Mistry

Rainer

2018

BMJ Open Sport Exerc Med

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BackgroundIn sport, concussion is assessed using the Sports Concussion Assessment Tool (SCAT) 5 and managed with return to play guidelines. Similar, user-friendly tools are rarely, if ever, used in the emergency department (ED).ObjectivesTo evaluate a modified concussion assessment tool designed for the ED (ED-CAT) in patients presenting with a head injury and to identify variables that predict 30-day reattendance.MethodsA preliminary, prospective, evaluation in a quality improvement project was conducted in one hospital in South Wales. Patients were recruited if they were over 13 years, and either did not have an ED-CT head scan or had a scan with no acute changes. The primary outcome was 30-day reattendance.Results40 patients were recruited, 18 of whom had a CT scan. 37 were discharged on the same day with advice, two discharged the next day and one was admitted. Three (7.5%) patients reattended the department. Predictors of reattendance were headache score (median 3.0 vs 5.0; p<0.05), pressure in head score (2.0 vs 5.0; p<0.05), nausea/vomiting score (1.0 vs 3.0; p<0.05), dizziness score (1.0 vs 4.0; p<0.05), blurred vision score (0 vs 4.0; p<0.01), balance problems score (0 vs 4.0; p<0.05), sensitivity to light and confusion score (0 vs 4.0; p<0.01), orientation score (1. 0 vs 0; p<0.05) and immediate memory score (5.0 vs 4.0; p<0.05).ConclusionsKey symptoms and signs predicted 30-day reattendance. The ED-CAT requires validation and refinement in a larger population to produce a short, practical, user-friendly, relevant tool for ED head injury assessment.

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Moving concussion care to the next level: The emergence and role of concussion clinics in the UK

Cited by 8 publications

References 52 publications

Managing concussion in the real world: Stakeholder perspectives of New Zealand Rugby's concussion management pathway

Managing concussion in the real world: Stakeholder perspectives of New Zealand Rugby's concussion management pathway

Concussion Knowledge and Self-Reported Behaviors in Youth Rugby Players and Their Coaches: A Population-Wide Cross-Sectional Survey

Concussion assessment in the emergency department: a preliminary study for a quality improvement project

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