Sports Medicine Research: In the Lab & In the Field: Self-Reported Concussion Details Takes a Hit with High School Athletes (Sports Med Res)
Wednesday, May 31, 2017

Self-Reported Concussion Details Takes a Hit with High School Athletes

Relationship between concussion history and concussion knowledge, attitudes, and disclosure behavior in high school athletes

Register-Mihalik JK, Valovich McLeod TC, Linnan LA, Guskiewicz KM, Marshal SW. Clin J Sport Med. 2017; 27(3):321-324

Take Home Message: More targeted concussion education for high school athletes with a history of concussion is needed. Athletes with more prior concussions, especially negative experiences, are less likely to disclose symptoms, more likely to play with symptoms, and have poorer attitudes regarding concussion reporting.

Honest disclosures of concussions and associated attitudes is an issue among high school athletes, especially when an athlete had a previous negative experience. Healthcare professionals rely on athletes to be truthful when self-reporting symptoms so that an athlete can be evaluated or held from competition or practice until symptom resolution. Unfortunately, an athlete with a prior diagnosed concussion who experienced no negative impact to themselves, may not appreciate the value of concussion self-reporting in future incidents; however, there is little research to confirm if this is occurring. Hence, the researchers expanded on their prior investigation to assess the connection between self-reported concussion history and disclosure, knowledge, and attitudes of high school athletes. A convenience sample of athletes from 25 high schools in six sports (167 athletes) filled out a survey regarding demographics, previous concussion events, self-reporting of concussions, and attitudes and knowledge of concussions during their high school years. Among 44 athletes with at least one recalled concussion, less than half of the 84 recalled concussions were reported to professionals. Furthermore, 32% of those athletes with unreported concussions participated in competition and 26% participated in a formal practice while symptomatic. Athletes with a prior concussion were less likely to disclose subsequent concussions and more likely to continue sport participation while symptomatic. For every three recalled concussions, the researchers found a decrease in overall attitude towards concussions. They found no relationship between recalled concussions and concussion knowledge.

Athletes withhold information about their concussion symptoms for a variety of reasons that may include a previous negative experience (such as lost playing time); societal behaviors and negative attitudes from parents, coaches or teammates; or a lack of knowledge about the potential consequences of reporting their concussion. Interestingly, the researchers do not believe disclosure can be improved via concussion knowledge, probably because these athletes already have sufficient information from previous concussion events. Instead efforts should be targeted to changing attitudes toward concussions. The researchers admit that the study failed to account for concussions sustained prior to high school and the athletes surveyed were predominately football athletes. Regardless, clinicians can still use these results across all high school athletes and the information can be extrapolated to other sports and age-groups. Clinicians should be mindful of their patient’s knowledge and attitudes pertaining to their concussion history and should focus on the underlying factors or attitudes behind an athlete’s failure to disclose symptoms. Building a good relationship with parents, coaches, and athletes will improve trust and guide efforts for education and improving attitudes toward reporting.
 
Questions for Discussion: Have you noticed concussion perception and reporting improved with education? What methods do you use to increase self-reporting of concussion signs and symptoms?

Written by: Catherine E. Lewis
Reviewed by: Jeffrey Driban

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Register-Mihalik, J., Valovich McLeod, T., Linnan, L., Guskiewicz, K., & Marshall, S. (2017). Relationship Between Concussion History and Concussion Knowledge, Attitudes, and Disclosure Behavior in High School Athletes Clinical Journal of Sport Medicine, 27 (3), 321-324 DOI: 10.1097/JSM.0000000000000349

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