Return to Learning After a Concussion and Compliance With Recommendations for Cognitive Rest
- 1 March 2016
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of Sport Medicine
- Vol. 26 (2), 115-119
- https://doi.org/10.1097/jsm.0000000000000208
Abstract
Objective: To determine the compliance of schools and school nurses in the United States with national recommendations for cognitive rest in students who sustain a concussion. Design: Cross-sectional questionnaire based. Participants: Members of the National Association of School Nurses working at the high school level. Intervention: A questionnaire, developed by the authors and based on recommendations for cognitive rest, was electronically distributed 3 times during the 2012 to 2013 academic year. Main Outcome Measures: Self-reported responses were collected regarding demographics and compliance of schools and school nurses with recommendations for the management of the postconcussion student, including the presence of specific guidelines for individualized care and the responsibility of the nurse for the prevention, detection, and management of concussions. Results: Analysis was performed on 1033 completed questionnaires (36% usable response rate). Fifty-three percent of schools have guidelines to assist students when returning to school after a concussion. These guidelines include extension of assignment deadlines (87%), rest periods during the school day (84%), postponement or staggering of tests (75%), reduced workload (73%), and accommodation for light or noise sensitivity (64%). Sixty-six percent of nurses in our sample have had special training in the recognition and management of concussions. Nurses reported involvement in the following roles: identifying suspected concussions (80%), providing emotional support for recovering students dealing with concussion-related depression (59%), and guiding the student's postconcussion graduated academic and activity re-entry process (58%). Conclusions: We detected a wide variability in compliance of schools and school nurses with national recommendations for cognitive rest. Clinical Relevance: Ensuring that schools have policies established for a student's return to learning, having specific guidelines to provide an individualized approach to return to learning based on postconcussion signs/symptoms, training school nurses in the recognition and management of concussions, and involving school nurses in the re-entry process are identified areas for improvement. Schools in the United States should be aware of these recommendations to guide a student's postconcussion graduated academic re-entry process.Keywords
This publication has 11 references indexed in Scilit:
- National High School Athlete Concussion Rates From 2005-2006 to 2011-2012The American Journal of Sports Medicine, 2014
- Returning to Learning Following a ConcussionPEDIATRICS, 2013
- Consensus Statement on Concussion in Sport—the 4th International Conference on Concussion in Sport Held in Zurich, November 2012Clinical Journal of Sport Medicine, 2013
- Efficacy of Immediate and Delayed Cognitive and Physical Rest for Treatment of Sports-Related ConcussionThe Journal of Pediatrics, 2012
- Epidemiology of Concussions Among United States High School Athletes in 20 SportsThe American Journal of Sports Medicine, 2012
- Sport-Related Concussion in Children and AdolescentsPEDIATRICS, 2010
- Supporting the Student-Athlete's Return to the Classroom After a Sport-Related ConcussionJournal of Athletic Training, 2010
- Concussion in Sports: Postconcussive Activity Levels, Symptoms, and Neurocognitive PerformanceJournal of Athletic Training, 2008
- Prolonged recovery of memory functioning after mild traumatic brain injury in adolescent athletesJournal of Neurosurgery, 2008
- Tracking neuropsychological recovery following concussion in sportBrain Injury, 2006