Use of the stepwise progression return-to-play protocol following concussion among practicing athletic trainers.

Purpose: The purpose of this study was to determine whether practicing athletic trainers (ATs) were using the stepwise progression to make return-to-play (RTP) decisions after concussion and to determine what factors influenced their decision to use the stepwise progression.

Methods: A total of 166 ATs (response rate = 16.6%) completed a 21-item questionnaire that evaluated participant demographics, methods of concussion management, and RTP decision-making using the stepwise progression. Descriptive statistics and a logistic regression were completed to analyze data.

Results: Factors such as education level ( p  = 0.05) and number of concussions treated ( p  = 0.05) predicted use of the stepwise progression, whereas sex ( p  = 0.17), employment setting ( p   =  0.17), state law ( p  = 0.86), and years practicing ( p  = 0.17) did not predict whether ATs were following the stepwise progression.

Conclusion: The majority of the ATs from this study are employing the stepwise progression to safely return athletes to play after sustaining a concussion. This demonstrates that ATs are providing a standard of care for concussed athletes across various athletic training settings; however, having a graduate degree and treating more concussions per year are predictors of whether an AT follows all steps of the stepwise progression.