Abstract
BackgroundConcussion baseline testing has drawn criticism regarding its clinical utility in the community setting. Recent studies have suggested that baseline testing may have additional advantages, such as improving players’ concussion-related decisions. ObjectiveAs part of New Zealand Rugby’s community concussion management pathway, this study examined coaches’, players’, and physiotherapists’ perspectives of the perceived value, barriers, and facilitators of baseline testing.DesignA descriptive, pragmatic qualitative design was used for the investigation. SettingClub and school-level rugby union in New Zealand.ParticipantsParticipants included 13 coaches, 36 players, and 24 physiotherapists who were involved in the concussion management program. AssessmentParticipant perceptions were investigated using semi-structured interviews. Thematic analysis was used to analyse the data.ResultsStakeholder buy-in was reported to be a key driver to the success of baseline testing. Operational and contextual elements were both barriers to and facilitators of the baseline testing process. According to participants, baseline testing had a favourable impact on i) concussion knowledge, and awareness, and created a positive culture around concussion; ii) perception that New Zealand rugby is taking player welfare seriously and ii) contributed to overall concussion care as part of the concussion management pathway. Although operational and contextual difficulties exist, these participants —who are significant stakeholders in the process — felt that the benefits of baseline testing exceeded the drawbacks. However, the magnitude of contextual and operational barriers may necessitate further consideration and support.ConclusionBaseline testing may have benefits beyond supporting the clinical assessment of concussion, by enhancing community awareness and knowledge, and by cultivating a positive culture around concussions. The results of this study could be used to further inform decision-making regarding the inclusion of pre-season baseline testing in community rugby.