Date of Graduation


Document Type


Degree Type



College of Physical Activity and Sport Sciences


Athletic Training

Committee Chair

Michelle A Sandrey


Context. Cerebral concussions are a common injury in the sport of football. To evaluate, manage, and make return to play decisions for concussions, the sports medicine community has access to various protocols. These various protocols recommend a multifaceted approach to accurately diagnose and treat athletes with concussions, but it is questioned whether this occurs. Objective. To investigate current trends of head football certified athletic trainers in concussion evaluation, management, and return-to-play. The secondary purpose of this study was to examine head football athletic trainers use of the NATA position statement as it pertains to evaluation, management, and return-to-play. Design. This study was a prospective descriptive analysis, which identified the current trends in concussion evaluation, management, and return-to-play. Setting: National Collegiate Athletic Association Division I, II, III, and Sub-Division institutions. Patient and participants. The study included the head football athletic trainers at 120 Division I, 116 Sub-Division, 148 Division II, and 240 Division III institutions for a total of 624. There were 197 athletic trainers returned the survey which accounts for a 32.6% return rate. This was a sample of convenience by including every NCAA institution in each Division that had a varsity football program. The participants were included because of their exposure to concussions. The subjects that were excluded were certified athletic trainers that were not head football athletic trainers for their institution. Intervention . Survey questions addressed topics including demographics, years of certification, number of concussions evaluated each year, methods of assessing concussions, management, and return-to-play. It also examined athletic trainers compliance with the NATA position statement on concussions. The subjects were contacted via e-mail. The e-mail directed the participants to the Survey Monkey website where they completed the electronic survey. The participants were again contacted two weeks later with a follow-up e-mail. Main outcome measures. Based on the responses there will be differences between all four divisions in regard to evaluation, management, and return to play decisions. There will also be a difference between athletic trainers who have been certified longer then ten years when compared to athletic trainers that have less then ten years of experience; as well as those with and without 10 years of experience as a head football athletic trainer. Results . Certified head football athletic trainers evaluated an average of 6.3+/-4.3 concussions per year. To assess concussions, clinical examination (98%), symptoms checklists (76%), Standardized Assessment of Concussion (37%), neuropsychological testing (57%), and the Balance Error Scoring System (24%) were used. The management of athletes consisted of rest, followed by neuropsychological testing. When deciding to return an athlete to play, certified athletic trainers most often used the clinical examination (98%), symptom checklists (61%), and player self-report (40%). Eighty-five percent of head football certified athletic trainers surveyed reported complying with the NATA position statement. Chi-Square results indicated that there was a significant difference between the divisions of NCAA collegiate football. Baseline testing and severity grading were shown to be significantly different between the four divisions with Division II having significantly lower rates of baseline testing and grading.;Conclusion. Based on the results of the survey, head certified football athletic trainers are using most of the NATA recommended concussion guidelines. However, they are not following the recommendations of a Balance Error Scoring system and symptom checklists for return-to-play of an athlete following a concussion.