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

A concussion is considered a mild TBI that may cause physical, cognitive, affective, and sleep dysfunction. Physical therapists have been identified as a health care provider involved in the multidisciplinary care of a patient with concussion. The purpose of this study was to describe the current attitudes and beliefs, knowledge, and practice of physical therapists in the management of patients with concussion. A 55 question electronic survey divided into six sections: (1) demographics, (2) current practice, (3) concussion legislation, (4) attitudes and beliefs, (5) concussion knowledge, and (6) clinical decision making was developed and distributed online through selected APTA sections. A total of 1,272 physical therapists completed the survey. Seventy percent of the respondents (n=894) reported having concussion training. While supportive of the role of the physical therapist in the management 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 management of youth who sustain a concussion, and anticipated normal CT/MRI after a concussion. When provided with clinical scenarios, respondents were able to recognize when a referral to a physician was indicated; however, demonstrated variability in identifying a need for vestibular or manual physical therapy.

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.