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. 2021 Winter;73(1):90-99.
doi: 10.3138/ptc-2019-0048.

Concussion Management Practices for Youth Who Are Slow to Recover: A Survey of Canadian Rehabilitation Clinicians

Danielle M Dobney  1 , Isabelle Gagnon  2   3   4
Affiliations

Concussion Management Practices for Youth Who Are Slow to Recover: A Survey of Canadian Rehabilitation Clinicians

Danielle M Dobney et al. Physiother Can. 2021 Winter.

Abstract
in English, French

Purpose: The objective of this study was to estimate the scope of concussion management practices for youth used by Canadian rehabilitation clinicians. A secondary objective was to determine the use of aerobic exercise as a management strategy. Method: Members of the Canadian Association of Occupational Therapists, Canadian Athletic Therapists Association, and Canadian Physiotherapy Association were invited to participate in an online cross-sectional survey. Two clinical vignettes were provided with a brief history. The respondents were asked about the type of treatments they would provide (e.g., manual therapy, education, aerobic exercise, return-to-learn or return-to-play protocol, goal setting). Results: The survey was completed by 555 clinicians. The top five treatment options were education, sleep recommendations, goal setting, energy management, and manual therapy. Just more than one-third of the clinicians prescribed aerobic exercise. Having a high caseload of patients with concussion (75%-100%) was a significant predictor of prescribing aerobic exercise. Conclusions: A wide variety of treatment options were selected, although the most common were education, sleep recommendations, energy management, and goal setting. Few clinicians used aerobic exercise as part of their concussion management strategy.

Objectif : évaluer la portée des pratiques de prise en charge des commotions qu’utilisent les cliniciens canadiens en réadaptation auprès des adolescents. Un objectif secondaire consistait à déterminer l’utilisation de l’exercice aérobique dans les stratégies de prise en charge. Méthodologie : les membres de l’Association canadienne des ergothérapeutes, de l’Association canadienne des thérapeutes du sport et de l’Association canadienne de physiothérapie ont été invités à participer à un sondage transversal en ligne. Ils ont reçu deux scénarios cliniques accompagnés d’une brève histoire. Les répondants ont été invités à indiquer le type de traitements qu’ils prodigueraient (p. ex., thérapie manuelle, éducation, exercice aérobique, protocole de retour à l’apprentissage ou au jeu, établissement d’objectifs, etc.). Résultats : au total, 555 cliniciens ont rempli le sondage. L’éducation, les recommandations au sujet du sommeil, l’établissement d’objectifs, la gestion de l’énergie et la thérapie manuelle étaient les cinq principales options thérapeutiques. Un peu plus du tiers des cliniciens auraient prescrit l’exercice aérobique. Une forte charge de patients victimes d’une commotion (75 % à 100 %) était un prédicteur important de prescription d’exercice aérobique. Conclusion : les répondants ont sélectionné un vaste éventail d’options thérapeutiques, mais les plus courants étaient l’éducation, les recommandations au sujet du sommeil, la gestion de l’énergie et l’établissement d’objectifs. Peu de cliniciens intégraient l’exercice aérobique à leur stratégie de prise en charge des commotions.

Keywords: brain concussion; evidence-based practice; rehabilitation.

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