Evaluating Primary Care Management of Acute Sport-Related Concussion

in International Journal of Athletic Therapy and Training
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  • 1 University of North Carolina at Chapel Hill
  • 2 University of North Carolina School of Medicine
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Primary care providers (PCPs) are evaluating increasing numbers of concussions, but it is unknown how often they are documenting concussion-specific history and physical examination findings vital for this process. This study reviews clinical documentation to determine how PCPs are evaluating concussed patients. PCPs often did not document important aspects of concussion history, including dizziness (48%), nausea (48%), vision changes (54%), cognitive complaints (54%), emotional changes (83%), sleep difficulties (84%), and neck pain (87%). Additionally, they often did not document important aspects of a concussion physical examination, including detailed neurologic examination (73%), clinical cognitive assessment (87%), balance testing (59%), and neck evaluation (54%). Omitting these parts of the history and physical examination could result in a premature return to play.

Cools, Northam, and Carneiro are with the Department of Neurosurgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Boyd is with the Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Alexander is with the University of North Carolina School of Medicine, Chapel Hill, NC, USA. Mihalik and Guskiewicz are with the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Carneiro (kevin_carneiro@med.unc.edu) is corresponding author.
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