Abstract
Background: Pediatric sports-induced concussions have become a topic of interest and concern in the scientific community. Already, the literature is rich with studies that have identified numerous short-term and long-term consequences of childhood sports-induced concussions. However, there are very few studies that have identified how well the students who participate in concussion-prone sports and their coaches understand these consequences and how they can be avoided. This study aimed to explore student athletes' and their coaches' understanding of the concept of concussion and how it is managed both immediately after the injury occurs and during long-term recovery.Methods: This study utilized a qualitative design. The study was conducted in local and international schools in Singapore. Participants were recruited through purposive sampling. 42 student athletes aged 13–18 who participated in rugby, softball, football, cricket, volleyball, and/or water polo were recruited. Fourteen coaches who coached these same sports were also recruited. Four focus groups and three semi-structured interviews were conducted. Data collected were then analyzed with thematic analysis. Risk factors were assessed through four domains of focus: understanding of what concussion is; attitudes toward concussion; existing protocols for treating concussion; and return-to-school and return-to-play protocols. As this is a qualitative study, outcome measures were not identified.Results: Analysis of the data revealed four themes for each group. For student-athletes these included: limited understanding of concussion; non-reporting of injuries; variable supervision of athletes; and a lack of established return-to-school and return-to-play guidelines. For coaches these included: variable understanding of concussion; insufficient formal training in concussion management; limited medical support in managing injuries; and lack of understanding and adherence to return-to-school and return-to-play protocols.Conclusions: Of the themes identified, the most pressing was a lack of clearly defined return-to-play guidelines. This is an urgent issue that needs to be jointly addressed by healthcare professionals and schools with evidence-based guidelines.
Highlights
Pediatric sports-induced concussions have become a topic of interest and concern in the scientific community
Twenty (47.6%) were rugby players, 9 (21.4%) were football players, 6 (14.3%) were cricket players, 5 (11.9%) were softball players, 3 (7.1%) were water polo players, and 3 (7.1%) played other sports
Fourteen coaches were recruited in total, at which point data saturation was achieved. 11 coaches were interviewed over two focus group discussions (FGDs) that lasted ∼45–75 min, and the remaining three coaches were interviewed over three semi-structured interviews (SSIs) that lasted between 30 and 45 min
Summary
Pediatric sports-induced concussions have become a topic of interest and concern in the scientific community. Sports- and recreation-related concussions (SRRC) constitute significant injuries among children and adolescents [1]. In a study by McLeod et al [10], it was found that while most sports coaches are aware of the overt symptoms of concussion, many are unable to identify more subtle symptoms such as vision problems, sleep disturbances, and nausea. They found that 42% of coaches felt that loss of consciousness was required for the diagnosis of concussion, despite the Consensus Statement on Concussion in Sport [11] stating the contrary. These studies show that many coaches are unaware of critical aspects of concussion and how to manage it
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