Referral Patterns for Pediatric Sports-Related Concussion in One New England Health Care System

Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system. Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June 2022. Results: We identified 375 patients with concussions. These patients were most often evaluated by pediatrics (199; 53.1%) and sports medicine (160; 42.7%), with fewer evaluated by family medicine (28; 7.5%), internal medicine/pediatrics (8 patients; 2.1%), or internal medicine (6; 1.6%). The most common referrals were to physical therapy (40; 10.7%), sports medicine (21; 5.6%), psychology (11; 2.9%), and neurology (9; 2.4%). Sports medicine placed a significantly higher number of referrals (P \u3c .0001) than non-sports medicine disciplines. Discussion: Compared to prior research, fewer referrals were placed in this cohort of patients with concussion. Possible explanations include a larger population of uncomplicated concussions, the more rural setting in which this study occurred, or a lack of awareness of resources for further concussion care. Conclusions: Further investigation should be done to evaluate the causes of the reduced referrals and their impact on the recovery of pediatric athletes with concussion

Physical Activity as a Vital Sign

The AHA and ACSM (American College of Sports Medicine) count physical activity in terms of minutes, 150 being the recommendation. The benefits of regular exercise and physical activity are well researched, and yet many of our patients don’t meet this recommendation. Project goals: By September 30, 2020: •Obtain a physical activity vital sign on at least 90% of all patients which we can track just like other vital signs. •For those under the ACSM guidelines of 150 min per week an exercise Rx will be given in the after visit summary for at least 80% of patients