Physiotherapists' use of information in identifying a concussion: an extended Delphi approach.

Abstract

To determine the relative importance of signs and symptoms that a selected cohort of sports physiotherapists use to identify a sports concussion. A two-round Delphi methodology was used to achieve consensus in a cohort of 21 sports physiotherapists. A subsequent round involving an educational intervention provided the participants with an opportunity to modify their knowledge base through the provision of a relevant resource article. Participants provided 123 responses, which were grouped into eight descriptive categories with consensus (>80%) being reached for the importance of: cognition/orientation, memory, motor dysfunction and state of consciousness. The category "state of consciousness" remained the most important information source at the completion of the study. Participants placed considerable importance on the player's level of consciousness in their decision making. This would appear to be in conflict with recent trends to place greater importance on the role of symptoms in identifying a concussion.