title: National Collegiate Athletic Association Division I athletic trainers' concussion-management practice patterns.
abstract: BACKGROUND
  A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together.
  
  
  OBJECTIVE
  To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Online survey.
  
  
  METHODS
  A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%.
  
  
  METHODS
  The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined.
  
  
  RESULTS
  We identified high rates of multifaceted assessments (i.e., assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations.
  
  
  CONCLUSIONS
  Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.
authors.affiliation: *Department of Health and Kinesiology, Georgia Southern University, Statesboro;
authors.forename: Kassandra C
authors.initials: KC
authors.lastname: Kelly
authors.forename: Erin M
authors.initials: EM
authors.lastname: Jordan
authors.forename: A Barry
authors.initials: AB
authors.lastname: Joyner
authors.forename: G Trey
authors.initials: GT
authors.lastname: Burdette
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Buckley
mesh_terms: D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013177:Sports; D013178:Sports Medicine / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: baseline testing; head injuries; return to participation