Sport-related concussion practices of medical team staff in elite football in the United Kingdom, a pilot study

Objectives: Explore sport-related concussion (SRC) awareness, behaviours and attitudes of medical team staff working in elite football in the United Kingdom. Including usage and awareness of the FA guidelines, concussion education rates of players and coaching staff, and collection of baseline concussion assessments. Additionally, pitch-side confidence in SRC recognition, associated perceived influence of players, coaching staff, referees and other officials on decisions, and attitude towards a “concussion” substitute were explored. Methods: Cross-sectional questionnaire study distributed online by organisations including or representing medical staff working in elite football in the United Kingdom. Results: 120 responses were gathered. High awareness rates of the FA guidelines were found (97%) with variable rates of player and coaching staff concussion education. Baseline concussion assessments were collected by 78%. Of those, 99% collected SCAT5 with low rates of other neuro-psychometric testing (17%). Confidence of pitch-side SRC recognition was high (93% feeling very confident or confident). A small number of respondents thought players never under-reported symptoms to avoid removal (6.6% selecting it rarely or never occurred). There is a perception of coaching staff trying to influence removal decisions with 40% often or sometimes feeling influence. Introduction of a “concussion” substitute was seen as strongly positive for player welfare (85% strongly agreeing or agreeing). Conclusions: High awareness rates of the FA concussion guidelines are not consistent with adherence to recommendations around baseline concussion assessment and concussion education. Confidence in SRC recognition was high but removal decisions could be subject to attempted influence by players and coaching staff.