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Rehabilitation Staff Have a Good General Understanding of Concussion, but Could Benefit from Learning More

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

A concussion is a mild brain injury that may occur after a fall or sudden impact to the head, such as during contact sports. It can cause symptoms such as headaches, confusion, or trouble concentrating, which can last for up to three months after injury. It is important for rehabilitation staff, from physicians and therapists to athletic trainers, to know how to accurately diagnose a concussion, how long it typically lasts, and what advice or therapy is appropriate to help individuals manage their symptoms and recovery. In a recent NIDILRR-funded study, researchers tested the concussion knowledge of staff at rehabilitation hospitals around the country. They wanted to find out what the staff already knew about concussions and whether there were gaps in their knowledge. They also wanted to see if concussion knowledge differed between types of staff, or if it was higher for staff with more experience or with specialized concussion training.

Researchers at the North Texas Traumatic Brain Injury Model System Center surveyed the concussion knowledge of 561 staff at rehabilitation hospitals around the country. The staff represented a variety of professions, including physical therapists, athletic trainers, occupational therapists, physicians, nurses, and psychologists. The staff completed a ten-question quiz about concussions, which included true/false and multiple-choice questions regarding the causes and symptoms of concussions; how long it takes to recover from symptoms; what activity restrictions and therapies are appropriate; and long-term effects of a concussion. Staff also answered questions about their profession, whether or not they had concussion-specific training, and how many years of experience they had in the field.

The researchers found that:

  • Most of the staff gave correct answers to the questions about concussion causes and symptoms. For example, they understood that a concussion can occur without direct contact to the head, and that a person can have a concussion without losing consciousness. The staff were also generally correct about how long concussion symptoms usually last.
  • The staff had more difficulty answering questions about recovery and treatment. For example, more than half thought that people should suspend physical and mental activities for at least a week after a concussion, but the current recommendation is to suspend activity for only 2-5 days or until symptoms improve. Some staff also thought that people should receive multiple therapies right after a concussion, but current research shows that in most cases, these therapies are unnecessary.
  • Some staff also had gaps in their knowledge about long-term effects of concussions. Some thought that persistent symptoms were the result of a “more severe” concussion. However, research suggests that longer-lasting concussion symptoms are usually related to physical or psychological problems the person had before the concussion.
  • About 60% of the staff respondents reported having some concussion-specific training, and these staff gave a greater number of correct answers on the quiz compared with staff who did not have this training.
  • In addition, professionals who worked in sports clinics or who tended to see more patients with concussions, such as psychologists and athletic trainers, performed better on the quiz than other professionals with less concussion experience. However, performance on the quiz was unrelated to the number of years in the field.

In this study, rehabilitation staff reported a moderately high level of knowledge about concussion diagnosis and management. However, the authors noted areas in which rehabilitation staff could benefit from further training. Concussion training for rehabilitation staff could address the rehabilitation professional’s role in the recovery process as well as risk factors for long-term complications. Concussion-specific training may enable rehabilitation staff to provide appropriate care without over-prescribing activity restrictions or therapies. This training could benefit even the most experienced professionals, and hospitals may wish to offer training on a periodic basis to ensure that it reflects the most updated best practices.

To Learn More

The Model Systems Knowledge Translation Center creates and collects educational materials from the NIDILRR-funded Model TBI Centers across the US. Browse through their collection of factsheets, videos, InfoComics, and more at

The Centers for Disease Control and Prevention HEADS UP campaign offers several resources for healthcare providers including an online training program, diagnostic and assessment tools, discharge instructions and patient handouts, and return-to-play guidelines and management information:

To Learn More About this Study

Salisbury, D., Kolessar, M., Callender, L., and Bennett, M. (2017) Concussion knowledge among rehabilitation staff. (PDF) Baylor University Medical Proceedings, 30(1) 33-37. This article is available from the NARIC collection under Accession Number J75917.

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