Rehabilitation and return to sport in concussed athletes: A qualitative multi-case study


The Return to Sport protocol (RTS) is widely used to manage athletes' concussion rehabilitation process (McCrory et al., 2017). While the RTS provides recommendations for symptom management, there is limited consideration for the psychosocial factors influencing concussion rehabilitation. Thus, the purpose of this study was to explore the psychosocial factors that impacted university athletes' concussion rehabilitation throughout the RTS protocol of their most recent sports-related concussion. A case study of four Canadian university athletes (20-23 years old, one male and three females) was performed that consisted of timelining and two semi-structured interviews. Data was collected one month to five years post-concussion. Athletes used timelines to identify important events and experiences during their rehabilitation. Interviews explored the psychosocial factors of concussion rehabilitation and athletes' psychological readiness to return to sport. A cross-case inductive thematic analysis resulted in five overarching themes: a) Initial concussion response influenced by athlete's perception of concussion symptoms b) Athletes experience concussion related challenges returning to work and school c) Social agents influence athletes' experiences and perceptions of their concussion rehabilitation throughout the return to play process d) Athletes create time-sensitive rehabilitation goals around sporting events which have negative psychosocial effects when not achieved e) Athletes' perceptions and experiences of readiness to return to sport during concussion rehabilitation and their return to competitive play. These findings provide preliminary evidence of the complex psychosocial factors that influence concussed athletes' rehabilitation and readiness to return to sport within the Canadian university sport context.