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Concussion Attitudes and Beliefs, Knowledge, and Clinical Practice: Survey of Physical Therapists

Amy M. Yorke, Sheila Littleton, Bara A. Alsalaheen
DOI: 10.2522/ptj.20140598 Published 1 July 2016
Amy M. Yorke
A.M. Yorke, PT, PhD, NCS, Physical Therapy Department, University of Michigan–Flint, Flint, MI 48502 (USA).
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Sheila Littleton
S. Littleton, PT, DSc, PCS, Department of Intellectual and Developmental Disabilities, State of Tennessee, Nashville, Tennessee.
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Bara A. Alsalaheen
B.A. Alsalaheen, PT, PhD, Physical Therapy Department, University of Michigan–Flint.
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Abstract

Background A concussion is considered a mild traumatic brain injury that may cause physical, cognitive, affective, and sleep dysfunction. Physical therapists have been identified as health care providers involved in the multidisciplinary care of a patient with concussion.

Objective The purpose of this study was to describe the current attitudes and beliefs, knowledge, and practice of physical therapists in the treatment of patients with concussion.

Methods A 55-question electronic survey divided into 6 sections—(1) demographics, (2) current practice in concussion, (3) youth concussion legislation, (4) attitudes and beliefs toward concussion management, (5) concussion knowledge, and (6) clinical decision making—was developed and distributed online through selected American Physical Therapy Association sections.

Results A total of 1,272 physical therapists completed the survey. Seventy percent of the respondents (n=894) reported having concussion training. Although supportive of the role of the physical therapist in the treatment of a person with concussion, the respondents demonstrated less confidence when making return-to-play decisions. Respondents correctly answered, on average, 13 (out of 15) concussion knowledge questions, with gaps exhibited in understanding the clinical utilization of concussion severity scales, the conservative treatment of youth who sustain a concussion, and anticipated normal computed tomography and magnetic resonance imaging after a concussion. When provided with clinical scenarios, respondents were able to recognize when a referral to a physician was indicated; however, they demonstrated variability in identifying a need for vestibular or manual physical therapy.

Limitations Convenience sampling was utilized, limiting generalizability of the results of the study to the physical therapy profession as a whole.

Conclusion Physical therapists demonstrated a solid foundation of concussion knowledge, but gaps still existed. Future professional development opportunities should be developed to target identified gaps in knowledge and current practice patterns.

Footnotes

  • Dr Yorke and Dr Alsalaheen provided concept/idea/research design and data collection. All authors provided writing and data analysis. Dr Yorke provided project management and fund procurement. Dr Littleton provided participants and consultation (including review of manuscript before submission).

  • The authors thank the Acute Care, Education, Geriatrics, Home Health, Neurology, Orthopaedics, Pediatrics, Private Practice, and Sports sections for assisting in the dissemination of the survey to their members; the physical therapists who completed the survey; the Physical Therapy Department at the University of Michigan–Flint for financial support; and Jessica Smith, PT, DPT, Kayla Stockdale, BS, and Justin Diebold, BS, for assisting in the research on state concussion legislation.

  • The study was approved by the Institutional Review Board at the University of Michigan–Flint.

  • Received January 5, 2015.
  • Accepted November 22, 2015.
  • © 2016 American Physical Therapy Association
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Vol 96 Issue 7 Table of Contents
Physical Therapy: 96 (7)

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Concussion Attitudes and Beliefs, Knowledge, and Clinical Practice: Survey of Physical Therapists
Amy M. Yorke, Sheila Littleton, Bara A. Alsalaheen
Physical Therapy Jul 2016, 96 (7) 1018-1028; DOI: 10.2522/ptj.20140598

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Concussion Attitudes and Beliefs, Knowledge, and Clinical Practice: Survey of Physical Therapists
Amy M. Yorke, Sheila Littleton, Bara A. Alsalaheen
Physical Therapy Jul 2016, 96 (7) 1018-1028; DOI: 10.2522/ptj.20140598
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Subjects

  • Sports Physical Therapy
  • Neurology/Neuromuscular System
    • Traumatic Brain Injury
  • Pediatrics
    • Pediatrics: Other
  • Physical Therapist Practice
    • Professional Issues
    • Evidence-Based Practice
    • Clinical Decision Making

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