Assessment and Management of Concussion in Young Athletes: A Primary Care Module

• Main Author: Kleinjan, Christa Marie
• Format: Others
• Published: North Dakota State University 2015
• Online Access: http://hdl.handle.net/10365/24871

Concussion is a common sports injury in young athletes with the potential to cause negative consequence for the athlete due to improper concussion management and premature return-to-play. Primary care providers are often responsible for diagnosing, treating, and making return-to-play decisions for young athletes. Despite the recent onslaught of literature advocating for physical rest, cognitive rest, graduated return-to-play protocol, and appropriate referral, many providers neglect to include these recommendations in their treatment plan and patient education. An educational program “Concussion in Young Athletes: A Module for Primary Care Providers” was developed and delivered to primary care providers to address and improve these areas in practice. The module included three video vignettes to assess current and potential changes to provider treatment recommendations and an online PowerPoint Presentation. Data were collected for six weeks with 15 providers participating. Sixty-four percent of practicing providers diagnosed or treated a young athlete in the past year. One third of providers indicated they neither received concussion training during their MD, NP, or PA preparation nor completed training outside of their preparation. In the pretest, seventy-three percent neglected to include a return-to-play protocol in their recommendations for resuming sport. This was reduced to 40% following the module. In the pretest, one third of providers failed to refer an athlete with persistent concussive symptoms to a specialty provider. While little change was observed in the overall number of providers recommending physical rest, cognitive rest, and at school accommodations, notable improvements were made in the number of providers recommending return-to-play protocols and appropriate referrals for athletes with prolonged concussive symptoms. Comparing the cumulative pre and posttest scores, following the module providers scored an average of +2.7 points, or 11%, higher. After the module all providers (n=15, 100%) reported planning to make changes to their practice and general increases in knowledge and confidence were seen. After viewing the module, provider responses revealed improved practice recommendations and implemented return-to-play protocols. Results of the module indicated that additional educational opportunities for primary care providers should be advertised, offered, and possibly required to improve practice of managing concussions in young athletes.