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Concussions: Disconnect between awareness and application - is the gap…
Concussions: Disconnect between awareness and application - is the gap widening?
Knowledge
Parents
Some but not extensive impact from first aid and concussion training, though not significant in application to scenarios (Aussie Rules Football, n=1441)
Motivation to avoid official RTP clearance due to deeming it unecessary
Players
No significant differences between age groups, playing experience, and history of concussion (Aussie Rules Football n=284)
Not recognizing signs and symptoms as concussion-related, not understanding signs of readiness for return-to-play.
Coaches
Officials
More data needed!
School
Knowledge unknown, compliance lower in rural areas
Legislation
Rowan's Law (Canada)
Who can "decide" if you have a concussion
Impact of underreporting concussions
Stakeholders must be invested in order to meet the legal requirements and the purpose behind the legislation
US - all states have some sort of law
Doctors tend to support this legislation
NY study: school district compliance low in certain areas (such as parent information)
Tends to focus on RTP, not RTS or RTL
Major challenges: mandating training, following up on compliance, placing blame appropriately
Medical
Pediatric Protocol Development
24-48 hour rest period
Symptom-guided exercise
Prolonged rest now associated with negative outcomes
Healthcare provider support
Thorough discharge/follow-up information with examples
Updated Protocols
Influence of doctors on RTP compliance
Completion of concussion-specific training correlates with likelihood of developing/prescribing individualized treatment plan
Need to increase communication between doctors and other stakeholders
Inconsistent discharge advice
More children who seek concussion care receive thorough medical care, as measured by follow-up appointments. However, about 2/3 are still not seeking care.
Return-to-...
Activity
Especially for younger children!
More understanding about all activity influencing recovery (not just sport and learning activity)
Play
Main focus of legislation, protocols, coach ed, etc.
School
RTS and RTL protocols lagging behind RTP
Gradual classroom reintegration protocols needed
Could be modeled on 504 plans
cognitive activity strongly linked with delay in healing
Consistency is essential!
Challenges
Requirement for medical clearance can undermine protocol compliance (and concussion reporting) when access is limited
Archetype of athlete triumphing over injury