College Athletic Trainers’ Perceptions of Rest and Physical Activity When Managing Athletes With a Sport-Related Concussion

in Journal of Sport Rehabilitation

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Kyle M. Petit
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Tracey Covassin
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Context: Cognitive and physical rest are commonly utilized when managing a sport-related concussion (SRC); however, emerging research now suggests that excessive rest may negatively impact recovery. Despite current research recommendations, athletic trainers (ATs) may be behind in implementing this emerging research into clinical practice. Objective: To assess college ATs’ perceptions and implementation of an emerging SRC management approach (cognitive and physical rest and activity). Design: Cross-sectional study. Setting: Survey. Participants: A total of 122 (11.8%) ATs (53.3% female; 10.8 [9.8] y experience; 8.7 [6.9] SRCs managed annually) responded to the survey, which was randomly distributed to 1000 members of the National Athletic Trainers’ Association, as well as 31 additional ATs from varying universities. Main Outcome Measures: A 5-point Likert scale assessed the ATs’ perceptions and clinical practices as they relate to specific athlete behaviors (ie, texting, sleeping). The ATs were asked about their willingness to incorporate physical activity into clinical practice. Results: Playing video games (95.9%) and practicing (93.4%) were the activities most perceived to extend SRC recovery. However, sleeping more than usual (7.4%) and increased time in a dark environment (11.5%) were viewed as less likely to extend recovery. ATs restricted practicing (98.4%) and working out (91.8%) for athletes with SRC, while sleeping more than usual (6.6%) and increased time in a dark environment (13.1%) were less restricted. About 71% of the ATs would implement light physical activity for athletes with a symptom score of 1 to 5, 31% with scores of 6 to 10, and 15% with scores of 11 to 20. About 43%, 74%, and 97% believe that light, moderate, and vigorous physical activity, while symptomatic, will extend recovery, respectively. Conclusions: The ATs were receptive to including light physical activity into their SRC management, although only in certain situations. However, most ATs’ beliefs and clinical practices did not completely align with emerging research recommendations for the management of SRCs.

The authors are with the Department of Kinesiology, Michigan State University, East Lansing, MI, USA.

Petit (petitkyl@msu.edu) is corresponding author.
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  • 1.

    McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838847. PubMed ID: 28446457 doi:10.1136/bjsports-2017-097699

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    McCrea M, Guskiewicz KM, Marshall SW, et al. Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003;290(19):25562563. PubMed ID: 14625332 doi:10.1001/jama.290.19.2556

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Kontos AP, Braithwaite R, Dakan S, Elbin RJ. Computerized neurocognitive testing within 1 week of sport-related concussion: meta-analytic review and analysis of moderating factors. J Int Neuropsychol Soc. 2014;20(3):324332. PubMed ID: 24521662 doi:10.1017/S1355617713001471

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Kerr ZY, Zuckerman SL, Wasserman EB, Covassin T, Djoko A, Dompier TP. Concussion symptoms and return to play time in youth, high school, and college American Football Athletes. JAMA Pediatr. 2016;170(7):647653. PubMed ID: 27135397 doi:10.1001/jamapediatrics.2016.0073

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on concussion in sport—the third international conference on concussion in sport held in Zurich, November 2008. Phys Sportsmed. 2009;37(2):141159. PubMed ID: 20048521 doi:10.3810/psm.2009.06.1721

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl Train. 2001;36(3):228235. PubMed ID: 12937489

  • 7.

    McCrea M, Guskiewicz K, Randolph C, et al. Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion. Neurosurgery. 2009;65(5):876882. PubMed ID: 19834399 doi:10.1227/01.NEU.0000350155.89800.00

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Thomas DG, Apps JN, Hoffmann RG, McCrea M, Hammeke T. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015;135(2):213223. PubMed ID: 25560444 doi:10.1542/peds.2014-0966

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Grool AM, Aglipay M, Momoli F, et al. Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents. JAMA. 2016;316(23):25042514. PubMed ID: 27997652 doi:10.1001/jama.2016.17396

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):7172. PubMed ID: 8555924

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med. 2011;104(12):510520. PubMed ID: 22179294 doi:10.1258/jrsm.2011.110180

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Keeley K, Walker SE, Hankemeier DA, Martin M, Cappaert TA. Athletic trainers’ beliefs about and implementation of evidence-based practice. J Athl Train. 2016;51(1):3546. PubMed ID: 26845629 doi:10.4085/1062-6050-51.2.11

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    McCarty CW, Hankemeier DA, Walter JM, Newton EJ, Van Lunen BL. Use of evidence-based practice among athletic training educators, clinicians, and students, part 2: attitudes, beliefs, accessibility, and barriers. J Athl Train. 2013;48(3):405415. doi:10.4085/1062-6050-48.2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    National Collegiate Athletic Association. NCAA Active Members Directory Web Site. 2020. https://web3.ncaa.org/directory/memberList?type=1. Accessed December 8, 2018.

    • Search Google Scholar
    • Export Citation
  • 15.

    Lynall RC, Laudner KG, Mihalik JP, Stanek JM. Concussion-assessment and -management techniques used by athletic trainers. J Athl Train. 2013;48(6):844850. PubMed ID: 24143906 doi:10.4085/1062-6050-48.6.04

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Buckley TA, Burdette G, Kelly K. Concussion-management practice patterns of national collegiate athletic association division II and III athletic trainers: how the other half lives. J Athl Train. 2015;50(8):879888. PubMed ID: 26196701 doi:10.4085/1062-6050-50.7.04

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Leddy JJ, Haider MN, Hinds AL, Darling S, Willer BS. A preliminary study of the effect of early aerobic exercise treatment for sport-related concussion in males. Clin J Sport Med. 2019;29(5):353360. PubMed ID: 30239422 doi:10.1097/JSM.0000000000000663

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Leddy JJ, Cox JL, Baker JG, et al. Exercise treatment for postconcussion syndrome: a pilot study of changes in functional magnetic resonance imaging activation, physiology, and symptoms. J Head Trauma Rehabil. 2013;28(4):241249. PubMed ID: 23249769 doi:10.1097/HTR.0b013e31826da964

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Leddy JJ, Kozlowski K, Donnelly JP, Pendergast DR, Epstein LH, Willer B. A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clin J Sport Med. 2010;20(1):2127. PubMed ID: 20051730 doi:10.1097/JSM.0b013e3181c6c22c

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Harmon KG, Clugston JR, Dec K, et al. American medical society for sports medicine position statement on concussion in sport. Clin J Sport Med. 2019;29(2):87100. PubMed ID: 30730386 doi:10.1097/JSM.0000000000000720

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Becker KL. Individual and organisational unlearning: directions for future research. Int J Organ Behav. 2005;9(7):659670.

  • 22.

    Willer BS, Haider MN, Bezherano I, et al. Comparison of rest to aerobic exercise and placebo-like treatment of acute sport-related concussion in male and female adolescents. Arch Phys Med Rehabil. 2019;100(12):22672275. PubMed ID: 31377190 doi:10.1016/j.apmr.2019.07.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Leddy JJ, Haider MN, Ellis MJ, et al. Early subthreshold aerobic exercise for sport-related concussion: a randomized clinical trial. JAMA Pediatr. 2019;173(4):319325. PubMed ID: 30715132 doi:10.1001/jamapediatrics.2018.4397

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Welch CE, Hankemeier DA, Wyant AL, Hays DG, Pitney WA, Van Lunen BL. Future directions of evidence-based practice in athletic training: perceived strategies to enhance the use of evidence-based practice. J Athl Train. 2014;49(2):234244. PubMed ID: 24568230 doi:10.4085/1062-6050-49.2.15

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Press Room. National Athletic Trainers’ Association Web Site. 2019. https://www.nata.org/news-publications/press-room. Accessed December 8, 2019.

    • Search Google Scholar
    • Export Citation
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