Kahan Joseph B, Salzler Matthew, DiCenzo Danielle, Zink Thomas, Radford Zachary, Tybor David
Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut.
Tufts Medical Center, Department of Orthopaedic Surgery, Boston, Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2020 Sep 22;2(5):e563-e567. doi: 10.1016/j.asmr.2020.07.002. eCollection 2020 Oct.
To assess statewide prevalence of medical access, concussion reporting, and concussion clearance rates of high school athletic departments in Massachusetts after the implementation of state-wide concussion legislation.
A random sample of 50 athletic directors (ADs) from Massachusetts high schools with an enrollment of >150 students was selected. A 10-minute electronic survey about access to athletic trainers and physicians, and concussion reporting and clearance practices was administered. Responses were anonymous.
The response rate was 80% (n = 40). In total, 90% of respondents were male. Median age and experience of respondents was 52 years old and 10 years, respectively. The median school size was 637 students, represented from all Massachusetts geographic athletic districts. ADs disclosed that on average, 12% (95% confidence interval 7%-20%) of concussions go unreported at their schools. In total, 16% of respondents reported that at least 1 in 4 of concussed athletes at their school returned to play without appropriate medical clearance, and 5% of ADs reported that not all of their coaches had undergone any form of concussion training. Overall, 55% of high schools do not have access to a full-time athletic trainer and 50% do not have a team physician; 20% have affiliations with an orthopaedic surgeon and 8% with a neurologist.
Despite new regulations in Massachusetts, high school ADs report concussion reporting and clearance that are less than 100%. Less than one half of all Massachusetts high schools report access to a full-time athletic trainer or formal relationship with a school physician.
Investigating compliance with Massachusetts school athletics safety regulations could help identify a need for reform of policies designed to help schools keep student athletes safer in situations where a concussion may have occurred.
评估马萨诸塞州全州范围的脑震荡立法实施后，该州高中体育部门的医疗服务可及性、脑震荡报告率及脑震荡解禁率。
从马萨诸塞州学生人数超过150人的高中中随机抽取50名体育主任进行调查。开展一项时长10分钟的电子调查，内容涉及获得运动训练师和医生服务的情况，以及脑震荡报告和解禁措施。调查采用匿名方式。
回复率为80%（n = 40）。受访者中90%为男性。受访者的年龄中位数和工作经验中位数分别为52岁和10年。学校规模中位数为637名学生，涵盖马萨诸塞州所有地理体育区域。体育主任透露，他们学校平均有12%（95%置信区间7%-20%）的脑震荡未被报告。总体而言，16%的受访者表示，他们学校至少四分之一的脑震荡运动员在未获得适当医疗解禁的情况下就重返赛场，5%的体育主任表示并非所有教练都接受过任何形式的脑震荡培训。总体来看，55%的高中没有全职运动训练师，50%没有队医；20%与骨科医生有合作关系，8%与神经科医生有合作关系。
尽管马萨诸塞州出台了新规定，但高中体育主任报告的脑震荡报告率和解禁率仍未达到100%。马萨诸塞州不到一半的高中表示有全职运动训练师或与学校医生有正式合作关系。
调查马萨诸塞州学校体育安全法规的遵守情况有助于确定是否需要改革相关政策，以帮助学校在可能发生脑震荡的情况下让学生运动员更安全。
