A international cross-sectional study examining knowledge and attitudes towards sport-related concussion in Touch

OBJECTIVE

To determine the current level of knowledge and attitudes towards sport-related concussion (SRC) amongst key stakeholders in touch rugby.

DESIGN

An international cross-sectional study. Participants n = 141 (male, n = 88; female, n = 53) from 15 Touch Associations.

MAIN OUTCOME MEASURE

Online questionnaire including non-validated sections captured participant characteristics, first aid training, previous concussion, awareness of SRC guidelines, combined with Rosenbaum Concussion Knowledge and Attitudes Survey. Distributed online to Touch athletes internationally. Concussion knowledge index (CKI) and attitude index (CAI) scores were calculated. A linear regression was performed to determine whether awareness of concussion, previous concussion and role affected CKI and CAI scores.

RESULTS

Median CKI and CAI scores were 21 ± 2.0 and 67 ± 6.3, respectively, across all key stakeholders. 39% of participants reported a previous SRC and 32% of respondents were aware of concussion guidelines form their Association. Regression analysis showed minimal influence of key contextual information on CKI and CAI.

CONCLUSIONS

Findings suggest that key stakeholders in Touch have high to very high knowledge and safe attitudes towards SRC. However, there were some areas where further improvement could be targeted by those involved in Touch such as individual associations at the direction of the sport's governing body.

Effect of Hearing Status on Concussion Knowledge and Attitudes of Collegiate Athletes

CONTEXT

Collegiate athletes who are deaf or hard-of-hearing (D/HoH) are diagnosed with concussions at a similar rate as athletes who are hearing; however, little evidence exists on knowledge and attitudes of athletes who are D/HoH toward concussions. This study aimed to examine differences in knowledge of and attitudes toward concussions between athletes who are D/HoH and athletes who are hearing.

DESIGN

Cross-sectional research design.

METHODS

Of the 310 athletes who are D/HoH and 430 athletes who are hearing that were invited to participate, 90 athletes who are D/HoH, and 72 athletes who are hearing completed the survey. The Rosenbaum Concussion Knowledge and Attitudes Survey was used to quantify knowledge of and attitude toward concussions. The Rosenbaum Concussion Knowledge and Attitudes Survey consists of the concussion knowledge index (CKI) and the concussion attitudes index (CAI) subscales. Linear regressions were run to test the association of hearing status with CKI and CAI scores. Pearson correlations were performed to determine relationships between CKI and CAI for athletes who are D/HoH and athletes who are hearing. Alpha level was set a priori at P ≤ .05.

RESULTS

Athletes who are hearing demonstrated a higher CKI component score (19.58 [2.19]) compared to athletes who are D/HoH (16.14 [3.31]; P < .001). There were no statistical differences in CAI between hearing groups (hearing: 57.18 [8.73], D/HoH: 55.97 [9.92]; P = .41). There was a moderate positive correlation between CKI and CAI (r = .58) for athletes who are D/HoH, while a weak positive correlation (r = .30) for athletes who are hearing was observed.

CONCLUSIONS

Athletes who are D/HoH have poorer knowledge of concussions but similar attitudes toward concussion as that of athletes who are hearing. Current concussion educational interventions are in written or spoken form which may not be inclusive to athletes who are D/HoH. Health care professionals should consider an athlete's preferred communication mode to improve the efficiency and effectiveness of education.

A cross-sectional study examining Nigerian footballers' knowledge and attitudes towards sport-related concussion and associated contextual factors

OBJECTIVE

To examine Nigerian footballers' knowledge and attitudes towards sport-related concussion (SRC) and associated contextual factors.

METHODS

A cross-sectional study design was used with an online questionnaire distributed to Nigerian footballers affiliated with a registered team. The questionnaire included demographic information and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS-ST). The concussion knowledge index (CKI, 0-25) and attitude index (CAI, 15-75) were calculated. The association between various contextual factors with "high" knowledge and attitude were determined.

RESULTS

A total of 331 participants completed the questionnaire from 10 football clubs. Mean CKI and CAI scores were 14.0 ± 3.0 (56.2 ± 13.2%) and 54.5 ± 9.4 (72.6 ± 12.5%), respectively, and the association between scores was considered large (r = 0.530; 28%). A small proportion (n = 25; 7.6%) of participants reported a previous diagnosis of an SRC, with a further 40 (12.1%) suspecting they have suffered SRC. Thirty-five participants (10.6%) reported sustaining a SRC but did not seek medical help. Results indicated that men were at 4.8 times greater odds of having a "high[er]" CKI than women, and that those with 5-10 years playing experience had lower odds of a "high" CKI than those with >10 years' experience. Men had 7 times greater odds of having a "high" CAI than women.

CONCLUSION

The results of this study suggest that Nigerian footballers have a moderate level of SRC knowledge, satisfactory symptom recognition, and high SRC attitudes. Those working with Nigerian football may consider these findings when seeking strategies to improve concussion knowledge, potentially by improving attitudes and considering sex and playing experience.

Investigation of concussion knowledge and attitudes of Chinese amateur adolescent soccer athletes

Concussions are a common traumatic brain injury in soccer games but are often ignored by coaches and athletes. The purpose of our study is to assess the concussion knowledge and attitudes among amateur adolescent soccer athletes in China. Data was collected from questionnaire surveying (Rosenbaum Concussion Knowledge and Attitudes Survey (Student Version)) and semi-structured interviews completed by 69 amateur adolescent soccer athletes who participated in the U17 and U15 male groups of the 2022 China Youth Soccer League. The study followed a mixed methodology cross sectional study design. The concussion knowledge index (0-25) and concussion attitude index (15-75) scores were derived from the questionnaire and descriptive statistics were used for data analysis. The mean score of concussion knowledge is 16.8 ± 2.4 (range 10-22), and the mean score of concussion attitude is 61.3 ± 8.8 (range 45-77). Thematic analysis was used to categorize the participant's responses of the semi-structured interview and the results were compared with their survey answers of questionnaire. Interestingly, the interviews revealed the inconsistencies between the questionnaire responses and intended behaviors, and multiple factors (injury severity, the importance of the game and substitution rules) influencing concussion-reporting behaviors were identified. In addition, athletes hope to acquire concussion knowledge through formal education. Our study lay the foundation for educational interventions to potentially improve concussion-reporting behaviors among amateur adolescent soccer athletes.

Can Adults Recognize Concussion Symptoms? A Critical Review of Empirical Research Using the Rosenbaum Concussion Knowledge and Attitudes Survey

OBJECTIVE

The correct identification of concussion symptoms is vital for mild traumatic brain injury recognition, diagnosis, and injury management. Numerous surveys of symptom recognition have been conducted, including with athletes at-risk for injury. This critical, methodologically focused review aimed to: (1) discover which concussion symptoms are recognized, and (2) provide recommendations for future research.

DATA SOURCES

A quasi-systematic literature search was conducted to identify studies that used the Rosenbaum Concussion Knowledge and Attitudes Survey.

STUDY SELECTION

Eighty-five publications were identified, 8 of which were retained after screening.

DATA EXTRACTION

The identification of individual concussion symptoms was coded as good (a correct response by >90% of the sample), moderate (a correct response by 75%-90% of the sample), or poor (a correct response by <75% of the sample).

DATA SYNTHESIS

The pooled data comprised responses from more than 2000 individuals, most of whom were male, young adult, sport players. Overall, there was good recognition of 3 concussion symptoms (headaches, dizziness, and confusion), poor recognition of sleep disturbances, nausea, and loss of consciousness, and misattribution to concussion of 2 distractor symptoms (weakness of neck range of motion, difficulty speaking). The methodological evaluation revealed significant variability in symptom measurement.

CONCLUSIONS

The identified trends for concussion symptom recognition must be regarded as tentative because of the significant methodological variation in the reviewed studies. This variability affected the number, wording, and classification of items, and it restricted the data synthesis. This problem must be addressed in future research and recommendations are provided.

Concussion Management Plan Compliance: A Study of NCAA Power 5 Conference Schools

Background:

In response to concerns over concussions and repeated head impacts that occur during sports, the National Collegiate Athletic Association (NCAA) mandated that all member institutions enact a concussion management plan (CMP). Although institutional and health care provider self-reports have been investigated, compliance with NCAA protocol recommendations has not been examined.

Purpose:

To examine the CMPs from the 65 institutions within the NCAA Power 5 conferences for compliance with the NCAA 2015 concussion guidelines.

Study Design:

Descriptive epidemiology study.

Methods:

Each institution’s publicly available CMP was obtained in 2015, reviewed, and coded for compliance with each of the required 47 components. Overall compliance rate, item-level, category-level, and institution-level compliance was assessed. Independent predictors of compliance, including each institution’s athletic training staff size, academic performance, and athletic performance, were examined with quasi-binomial regression.

Results:

CMPs varied substantially in length and level of detail. The overall compliance rate for all components across all institutions was 94.3% (2880/3055). Twelve components achieved 100% (65/65) compliance, and the lowest levels of compliance were clustered in “return to learn.” There were 22 institutions that achieved a 100% compliance rate; the lowest institutional compliance was 59.6%. There were no significant associations between the independent predictors and institutional compliance.

Conclusion:

Overall compliance with NCAA concussion management requirements was high, but there remains room for improvement. The lowest level of compliance was clustered in the return-to-learn section. There were limited details provided in the reducing head trauma component. Items with lower compliance (reducing head trauma, return to learn) tended to be outside the core competencies of the medical staff, indicating an area for improvement. Encouragingly, many institutions and specific components demonstrated full compliance.

Concussion knowledge among amateur motocross riders

AIM

There has been considerable increase in concussion awareness and risks; however, extreme sports such as motocross have received scant attention. The purpose of this study was to assess concussion knowledge among motocross riders and determine differences based on demographic factors.

METHODOLOGY & RESULTS

782 motocross riders responded to an Internet-based questionnaire, and participant's knowledge score was 14.3 ± 2.7 out of 20 and symptom recognition was 6.8 ± 1.4 out of 8. Riders who had performed baseline concussion testing or received formal concussion education demonstrated higher knowledge scores. Rider's demographics did not predict outcome measures.

CONCLUSIONS

Considerable misconceptions and lack of symptom knowledge persist among motocross riders and these results can be used for future interventions to improve concussion reporting.

English professional football players concussion knowledge and attitude

BACKGROUND

Concussions are a common pathology in football and multiple misconceptions exist amongst the players and managers. To address these misconceptions, and potentially reduce concussion associated sequela, effective educational interventions need to be developed. However, the current knowledge and attitude status must be ascertained to appropriately develop these interventions. The purpose of this study was to assess the concussion knowledge and attitude of English professional footballers.

METHODS

Twenty-six participants from one English Football League Championship club completed the study. A mixed methods approach included the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) and a semi-structured interview. The RoCKAS contains separate knowledge (0-25) and attitude (15-75) scores and was followed by a semi-structured interview consisting of concussion knowledge, attitude, and behavior related questions.

RESULTS

The mean score on the RoCKAS knowledge was 16.4 ± 2.9 (range 11-22) and the attitude score was 59.6 ± 8.5 (range 41-71). The interview responses identified inconsistencies between the RoCKAS and the intended behaviors, endorsing multiple concussion misconceptions, and revealed barriers to concussion reporting.

CONCLUSION

The results of this study suggest that Championship Level English footballers have moderate concussion knowledge, safe attitudes, and good concussion symptom recognition when assessed with pen and paper questionnaires. However, within the semi-structured interview many respondents reported unsafe concussion behaviors despite accurately identifying the potential risks. Further, multiple barriers to concussion reporting were identified which included perceived severity of the injury, game situations, and the substitution rule. These findings can help form the foundation of educational interventions to potentially improve concussion reporting behaviors amongst professional footballers.