











































MANUSCRIPT TYPE


QUALITY IMRPOVEMENT REPORT 

 

52 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 5 – Issue 2 – September 2022 
 

Quality Improvement: Implementation of Individualized Concussion 
Patient Education and Rehabilitation Treatment Plans   
Briana Burgette, DAT, ATC; Tamara C. Valovich McLeod, PhD, ATC, FNATA 
*A.T. Still University, Mesa, AZ   

 
ABSTRACT 
Concussion is a significant health issue at all levels of sports participation. At Saint Luke’s Health System (SLHS) in Kansas City, 
Missouri, the sports medicine and concussion team discovered an issue with dissemination of patient education for concussion 
rehabilitation plans. A quality improvement project was launched in August 2019 to develop concussion educational rehabilitation 
plans, incorporating cluster symptoms into concussion profiles and improving communication during follow-up care. The project 
promoted improvement of patient understanding of individualized rehabilitation plans and effective communication for the treatment 
management team. Three cycles of a Plan-Do-Study-Act (PDSA) quality improvement project were completed over 6 months. The 
physicians and athletic trainers reviewed literature and treatment plan recommendations for patients. Comparison of pre-PDSA and 
post-PDSA adherence to charting standards was performed. Before this project, patients had insufficient documentation of the 
education they were receiving. Additional implementations included education, Patient Health Questionnaire (PHQ-9) score, graded 
symptom scale (GSS) score, and changes to the documentation template. Eighty patients (46 male, 34 female) were included in the 
6-month project. Of pre-PDSA (control) concussion patients, 71% (n=29) were male football players. After the PDSA cycles were 
completed, only 18% (n=7) of patients were football players. The season had no effect between the number of patients included 
pre-PDSA or PDSA cycles 1-3. For PDSA cycle 1, the pre-PDSA goal was surpassed, and 100% of new concussion patients received 
concussion education during their initial visit. During the 3-month data collection period for that cycle, only 10.5% (2/19) of follow-
up patients received a concussion information packet during their visit. After completion of PDSA cycle 2, 100% of patients received 
education pamphlets; initially, only 85% received pamphlets. Finally, PDSA cycle 3 successfully implemented the use of the new 
concussion template system-wide and the addition of concussion symptom profiles for patient education and individualized treatment 
planning. 
 
 
Correspondence 
Dr. Tamara C. Valovich McLeod, Athletic Training Programs and School  of  Osteopathic  Medicine  in Arizona,  A.T.  Still  University, 
5850 E. Still Circle, Mesa, AZ 85206.  
E-mail: tmcleod@atsu.edu 
Twitter: @TamaraCVMcLeod 
 
Full Citation 
Burgette B, Valovich McLeod TC. Quality improvement: Implementation of individualized concussion patient education and 
rehabilitation treatment plans. Clin Pract Athl Train. 2022;5(2): 52-60. https://doi.org/10.31622/2022/0005.02.9.        
 
Submitted: September 17, 2021, Accepted: January 12, 2022. 

 
CURRENT MODEL 

The original process for concussion rehabilitation at SLHS in Kansas City, Missouri, involved an initial clinical 
examination consisting of a physical examination, ImPACT test, Balance Error Scoring System test, and 
symptom score. Patients were then provided with academic supports, concussion education, and a signed 
Missouri State High School Activities Association or Kansas State High School Athletic Association concussion 
form for the school, which allowed the patient to begin the return-to-play progression with the athletic trainer 
once free of symptoms. If there were referrals to other providers for therapy, patient education was limited. 
The main therapies considered were vestibular/oculomotor (after 7 days), manual therapy for the cervical 
spine (if the patient had cervical pain), and neuropsychological evaluation for patients with persistent 
symptoms that did not resolve using alternative treatment plans.  

The primary issue addressed in this quality improvement project was the lack of individualized concussion 
rehabilitation treatment plans and patient education for these plans. Initially, the concussion rehabilitation 
treatment process at SLHS was limited, referring patients for a few therapy techniques while neglecting 
others. Typical treatment recommendations for patients were rest followed by a progression back to sport 
that gradually increased exertion.1 The primary method used to assess patient status was a self-reported 

mailto:tmcleod@atsu.edu
https://doi.org/10.31622/2022/0005.02.9


Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

53 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 5 – Issue 2 – September 2022 

 
 

symptom questionnaire.2 The Post-Concussion Symptom Scale was used for tracking symptoms throughout the 
recovery phase and has been reported as a useful tool for assessing concussions;3,4 however, it was only 
used to determine when symptoms resolved rather than to direct therapy.  As concussion treatment evidence 
continues to emerge, we felt we should be constantly innovating new ideas and processes throughout our 
sports medicine program. Recent evidence has identified presentations of SRC that have been termed 
profiles5 or subtypes.6 Various taxonomies have been developed that categorize symptoms in a somewhat 
different manner; but many include similar constructs, such as cognitive, emotional, vestibular, and ocular.7 
Furthermore, sleep and cervicogenic injury have been implicated as modifiers for any concussion profile.6 
We identified a gap in patient care from the resting phase through return to sport beyond the progression 
of exertion. 

Secondarily, there was limited communication with the patient and parents about the necessary steps 
required after initial evaluation. Patients did not take home any written information about their current 
rehabilitation plan. If a patient needed a specific therapy, the specialized office would call to schedule the 
therapy. The physician educated the patient and the parents in the office; but once they left the clinic, it was 
assumed they understood the next steps of the rehabilitation plan. The majority of the time the patients would 
call and ask additional questions because they forgot when they should begin therapy or when they could 
start their return-to-play progression.  

Therefore, the two primary aims of this quality improvement project were to (1) establish symptom profiles 
as part of each patient’s individualized treatment plan and (2) improve patient and parent education and 
understanding of concussion treatments and return to play. To identify changes that addressed the project 
aims, information from the comprehensive physical examination at the initial visit, adjunct assessments, and 
the symptom scale was used to assign a symptom profile to each patient. Ideally, the symptom profile would 
result in an appropriate individualized approach to the concussion treatment and management plan. A 
second change required using the information from the symptom profile assignment to better educate 
patients and parents about the next steps in their care and expectations for the recovery process. 
Measurable outcomes for this project included improving the percentage of patients assigned a concussion 
symptom profile and providing patient educational materials at the initial visit. 

PLAN-DO-STUDY-ACT (PDSA) CYCLES  

Baseline Evaluation 

Pre-PDSA (baseline) data were analyzed from August-September 2019 and included data from every 
concussion patient seen by SLHS sports medicine department during that period. An assessment of the 
treatment and rehabilitation plans that patients received was also performed. Three PDSA cycles were then 
used to establish necessary changes for improvements to patients’ concussion education, communication of 
rehabilitation and treatment plans, and electronic medical record (EMR) template changes for staff to ensure 
assignment of a concussion symptom profile. A summary of the sports patients participated in during the 6-
month project is presented in Figure 1.  

To complete the three PDSA cycles during the project, there was a 6-week delay, where no data were 
collected. Before the PDSA cycle 1 data collection period, 41 patients were identified as meeting inclusion 
criteria. However, 2 cases were excluded because the concussion was caused by a motor vehicle accident 
and the patient was not attending school. 



Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 5 – Issue 2 – September 2022 

 
 

 

Figure 1. Patient demographics per their sport. Blue: Pre PDSA1 Aug-Sept 2019 controlled data patients. Orange: PDSA2 Dec-Feb 
2020 patient’s data. 

In 15% (n=6/41) of pre-PDSA cases, it was unclear whether the patient received any concussion education 
material because that information was not documented in the EMR. For the other 85% of cases, it was clearly 
documented that the patient received concussion education. 

PDSA Cycle 1 

The first PDSA cycle focused on improvements in the use of concussion symptom scores through the 
development of concussion symptom profiles and modifications to the EMR. 

Plan: To implement concussion symptom profiles based on concussion symptom scores and physical 
examination findings for each patient, the clinical athletic trainer was responsible for obtaining the physical 
findings and categorizing patients into profiles after each examination. After the profiles were established, 
the implementation process took less than 5 minutes. Resources needed for PDSA cycle 1 included an up-to-
date concussion literature review, EMR training, and instruction from the information technology team to 
change the templates. This cycle was expected to require a month to plan because of constraints related to 
scheduling with others.  

Do: Five concussion symptom profiles were established to drive treatment plans. The concussion symptom 
profiles were discussed among the entire sports medicine team and informed by the concussion symptom 
cluster of the GSS. After the 5 symptom profiles were established, changes were made to the EMR template 
(Table 1) to create symptom profile groups within the documentation; the previous EMR template included 
only a total symptom severity score. Thus, PDSA cycle 1 resulted in changes to the entire healthcare EMR 
system that were not limited to the sports medicine physicians. More specifically, the templates were changed  

0

5

10

15

20

25

N
um

be
r 

of
 P

at
ie

nt
s 

Sport
Pre PDSA PDSA



Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 5 – Issue 2 – September 2022 

 
 

so, the exact symptoms that patients were 
experiencing reflected their symptom profile. 
One unexpected finding was the placement of 
a symptom in the correct profile when the 
symptom could be categorized in multiple 
profiles. For example, headache could arise 
from lack of sleep but is still a physical 
symptom.  

Study: Following this EMR change, we 
compared data from concussion patients 
evaluated during the current football season 
with those from the prior season (before 
individual plans were developed based on the 
symptom profile).  

Act: Based on the patient concussion symptom 
profiles, the sports medicine staff at SLHS 
developed and delivered individualized 
concussion treatment and rehabilitation plans, 
and concussion education for at least 90% of 
all new concussion patients during a 3-month 
period. 

According to PDSA cycle 1 data, in 66% 
(n=14) of pre-PDSA cases, patients received 
recommendations for academic supports 
during their visit with the physician. However, 
50% of patients who did not receive temporary academic adjustments were follow-up patients with a 
symptom score of 0 who were ready to be cleared for return to play. Changes between the proposed 
process map to the post-PDSA cycle process are presented in Figure 2.  

PDSA Cycle 2 

The second PDSA cycle was directed specifically toward staff communication and education training and 
how to effectively educate patients and parents about the individualized concussion rehabilitation and 
treatment plans. The addition of patient-reported outcomes (PROs) facilitated communication among the 
staff and improved visualization of patients’ documented outcomes.  

Plan: To build new concussion templates within the EMR, the sports medicine staff met weekly before clinic. 
These weekly meetings were needed to discuss the new templates and answer any questions about them. 
Saint Luke’s medical liaisons were part of the implementation process to ensure all concussion specialist 
physicians had access to the templates. The concussion templates were available for use across the entire 
health system for any provider who wanted to use the template. In addition to educating the staff about 
concussion template changes, finalizing the patient education pamphlets was included in the weekly meetings.  

Table 1. EMR template changes incorporating 
concussion symptom profiles. 
Review of symptoms (ROS) 
Physical Symptoms  

Headache (yes/no) 
Neck Pain (yes/no) 
Radicular Symptoms (yes/no) 
Vision Complaints (yes/no) 
Sound Complaints (yes/no) 

Mood Symptoms  
Sad/Depressed (yes/no) 
Irritable/Angry (yes/no) 
Anxious/Fearful? (yes/no) 
PHQ-9 Modified for Teens Score (0-30) 

Sleep Symptoms 
Hard to get sleep? (yes/no) 
Sleeping more than usual? (yes/no) 

Cognitive Symptoms  
Missing school/work (yes/no) 
Confusion/memory problems (yes/no) 
Distracted/attention problems (yes/no) 
Feeling foggy/slowed down/groggy (yes/no) 
Normal school grades 

Vestibular 
Dizziness (yes/no) 
Balance issues (yes/no) 
Car sickness (yes/no) 
Nausea/vomiting (yes/no) 

Physical Education 
Alert and oriented 
Answers questions appropriately 



Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

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Do: Communication and staff education were used to ensure everyone understood and used the templates 
the same way. The previous concussion template did not include symptom profiles and only included the 
patient’s graded symptom scale (GSS) total score. Improvements to the EMR template may have affected 
an observed increase in the number of documented patient PROs. An unexpected finding of this cycle was a 
lack of GSS scores for follow-up patients, which had been previously recorded. Staff were also unaware of 
how to document information in the EMR because of lack of training before PDSA cycle 2.  

Injury to head or neck resulting in 
concussion symptoms 

Visit concussion team within 48-72 hours 

History and physical exam consistent with 
concussion (Neurological exam, Balance Error 

Scoring System, cervical spine exam, 
vestibular testing, PHQ-9, CNN Symptom 

Scale) 

Refer to primary care or 
manage differential diagnosis 

Initial period of brain rest, school supports, 
no sports, Tylenol if needed 

Vestibular therapy if 
dizziness, nausea, 
positive vestibular 

Vision therapy, 
Behavioral therapy, 
if needed 

Physical therapy if 
cervicogenic headache, 
consider radiographs 

(listhesis) 

Symptom free in 2-3 weeks, re-evaluate by 
physician, return to sport protocol, and 

release to full school 

Consider imaging, 
neuropsychological testing, 

medications, behavioral 
psychology 

Yes 

Yes 

No
 

No 

Figure 2. Changes between the proposed process map to the post-PDSA cycle process 



Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                     Volume 5 – Issue 2 – September 2022 

 
 

Study: Notable changes were made to the EMR templates and patient education pamphlet. A staff meeting 
that included all members of the sports medicine and orthopedics team was conducted for staff education 
and training purposes. Topics discussed during the meeting included wording changes, where to find the new 
PROs, how to interrupt the PRO results, and the process for neurocognitive testing. The patient education 
pamphlet also included a change in patient instructions increasing the amount of time allowed for the brain 
to rest (48-72 hours) before beginning light exercise, the PROs given to the patient (GSS score, Patient 
Health Questionnaire [PHQ-9], and the number of times the patient completed neurocognitive testing 
(baseline, after injury, before return to play, and after clearance for a new baseline). 

Act: Table 2 presents data for this cycle (December 2019-February 2020). Improvements were made to the 
concussion education material the patient received and, subsequently, to the rehabilitation and treatment 
plans. New PRO measures, including the PHQ-9, were also added. Before PDSA cycle 2, 85% of patients 
received patient education; however, this number increased to 100% after the PDSA cycle 2.  

Table 2. Change in the percentage of patients with documented outcome measures prior to 
and following PDSA Cycle 2. 
Outcome Variable Pre-PDSA2 Post-PDSA2 
Patient education 85 100 
GSS 86 95 
PHQ-9 0 80 

 

PDSA Cycle 3 

The third PDSA cycle was structured to implement all the concussion education changes in the updated 
pamphlet that the patients and parents received.  

Plan: Individualized plans were highlighted on the concussion education handout for each patient. The 
concussion symptom profiles were listed using the American Medical Society for Sports Medicine overlapping 
symptom profiles, which is an emerging concept to facilitate individualized management after sport-related 
concussion.5-7 

Study: Marketing reviewed the size, color, and number of pages of the pamphlet before it was sent to 
production for printing.  

Do: Information was condensed in order to make the handout smaller. Further, all pictures were removed 
from the original concussion education handout to limit the number of pages.  

Act: Results for PDSA cycle 3 indicated the pre-PDSA goal was surpassed and 100% of new concussion 
patients received concussion education during their initial visit. During the 3-month PDSA cycle 1 data 
collection period, only 10.5% (2/19) of follow-up patients received a concussion information packet during 
their follow-up visit. Both of those follow-up patients were still experiencing symptoms. The new education 
handouts started being used after completion of PDSA cycle 3.  

 

 



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LESSONS AND LIMITATIONS 

While we successfully made improvements during this quality improvement project, several lessons were 
learned during the process, some of which were specific to our situation and some of which may benefit 
others interested in a quality improvement initiative at their institution. The first lesson learned was to extract 
data from the same season, same sport, and same time of year for better comparisons. Because of time 
constraints on the project, we were limited in this ability. However, we were fortunate that the population of 
pre-PDSA concussion patients during football season was similar to the population of post-PDSA concussion 
patients during the winter sports season.  

The second lesson learned was to involve other hospital system departments, such as marketing, before 
making specific pamphlet changes to ensure all formatting requirements of the organization were followed 
appropriately. The revision of the education pamphlet in PDSA cycle 3 was completed by department 
clinicians without consulting the hospital system’s marketing department. In hindsight, the sports medicine 
department should have focused solely on updating the content and then working collaboratively with 
marketing to ensure compliance with hospital branding, thus decreasing the number of edits required before 
printing.  

There are plans to continue this quality improvement project with a fourth PDSA cycle to facilitate to improve 
the nationwide implementation of the new SRC symptom profile and individualized concussion rehabilitation 
and treatment plans throughout the EMRs of this healthcare system. The EMR template changes can be shared 
system-wide and could also be used by providers in other healthcare networks that use the same EMR. 
Further, using the same template may decrease documentation errors and result in better patient care. It 
may also decrease the amount of time it takes clinicians to review previous patient records before follow-
up appointments. Financial savings may be another benefit resulting from decreases in documentation errors 
and the amount of time spent on documentation.  

Although this project focused solely on a single hospital department, the changes made and lessons learned 
can be applied to concussion protocols of other institutions. A similar concussion template could be used in 
other settings, such as industrial, performing arts, military, hospital, secondary school, or collegiate settings. 
The development of similar educational materials to improve patient understanding of other elements of 
concussion treatment and rehabilitation plans can also be replicated by other institutions.  

The evaluation and management of concussion has changed markedly in the past several years, and with 
our increased understanding of the effectiveness of active rehabilitation and treatment plans, we can expect 
these changes to continue. Active and targeted rehabilitation strategies, such as vestibular and oculomotor 
rehabilitation and pharmacological interventions, have emerging evidence supporting their use.8 The use of 
quality improvement processes to evaluate the concussion protocols of an institution or individual clinician is 
an important way to ensure contemporary practice and the provision of evidence-informed patient care. 
Further, continuously evaluating aspects of concussion management using PDSA cycles can help clinicians 
effect small changes over short periods to ease implementation burden. For this particular project, our focus 
was on simple changes to the educational materials provided to patients regarding their treatment plans; 
however, quality improvement strategies have also been used for the treatment of concussion to improve 
management of academic considerations9 and to ensure patients are provided education about driving.10 
To evaluate potential gaps in protocols, clinicians should review their concussion protocols annually and when 



Quality Improvement: Implementation of Individualized Concussion Patient Education and Rehabilitation Treatment Plans 

 

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updated consensus or position statements are published. A quality improvement process can then be initiated 
for implementation of those changes. 

CONCLUSION 

From a team approach perspective, miscommunication and lack of documentation for a patients with 
concussion may be detrimental to patient care. Since concussion patients are often treated by more than one 
healthcare professional, it is imperative that all healthcare professionals communicate with each other about 
the patient’s rehabilitation and treatment plan and, perhaps more importantly, that patients understand their 
follow-up care plans. This quality improvement project showed that modifications to the EMR to capture 
symptom clusters and assign symptom profiles and that revision of patient educational materials were 
effective improvements for concussion care.  

Utilizing a multidisciplinary approach and having effective communication among athletic trainers, coaches, 
and parents will ensure the patient’s concussion rehabilitation and treatment plans are implemented as 
prescribed. For athletic trainers in states that allow them to treat concussions on their own, symptom concussion 
profiles can be used to drive the treatment plans for each individual patient. Further, the concussion symptom 
profiles, and individualized treatment approach allow the patient to visualize their plan and helps them 
create short-term goals for each therapy session. Importantly, these goals can be shared and viewed by 
other healthcare professionals on the patient’s treatment team. Using concussion symptom profiles as a part 
of the SRC treatment plan can also guide athletic trainers when deciding whether it is appropriate to refer 
patients to specialty providers. Ultimately, a quality improvement approach is ideal because it allows 
clinicians to evaluate their protocols in relation to best practice documents and emerging evidence and to 
implement small changes for evaluation of outcomes in their specific setting.  

REFERENCES: 

1. Schneider KJ, Leddy JJ, Guskiewicz KM, et al. Rest and treatment/rehabilitation following sport-
related concussion: a systematic review. Br J Sports Med. 2017;51(12):930-934. 
http://dx.doi.org/10.1136/bjsports-2016-097475.  

2. McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport-the 5th 
international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 
2018;51:838-847. http://dx.doi.org/10.1136/bjsports-2017-097699.  

3. Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation 
and management of concussion in sports. Report of the Guideline Development Subcommittee of 
the American Academy of Neurology. Neurology. 2013;80(24):2250-2257. 
https://doi.org/10.1212%2FWNL.0b013e31828d57dd.  

4. Iverson GL, Gardner AJ, Terry DP, et al. Predictors of clinical recovery from concussion: a 
systematic review. Br J Sports Med. 2017;51(12):941-948. https://doi.org/10.1136/bjsports-
2017-097729.  

5. Kontos AP, Elbin RJ, Trbovich A, et al. Concussion Clinical Profiles Screening (CP Screen) tool: 
preliminary evidence to inform a multidisciplinary approach. Neurosurgery. 2020;87(2):348-356. 
https://doi.org/10.1093/neuros/nyz545.  

6. Lumba-Brown A, Teramoto M, Bloom OJ, et al. Concussion guidelines step 2: evidence for subtype 
classification. Neurosurgery. 2020;86(1):2-13. https://doi.org/10.1093/neuros/nyz332.  

http://dx.doi.org/10.1136/bjsports-2016-097475
http://dx.doi.org/10.1136/bjsports-2017-097699
https://doi.org/10.1212%2FWNL.0b013e31828d57dd
https://doi.org/10.1136/bjsports-2017-097729
https://doi.org/10.1136/bjsports-2017-097729
https://doi.org/10.1093/neuros/nyz545
https://doi.org/10.1093/neuros/nyz332


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7. Collins MW, Kontos AP, Okonkwo DO, et al. Statements of agreement from the Targeted 
Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting held in 
Pittsburgh, October 15-16, 2015. Neurosurgery. 2016;79(6):912-929. 
https://doi.org/10.1227/neu.0000000000001447.  

8. Langevin P, Frémont P, Fait P, Dubé MO, Bertrand-Charette M, Roy JS. Aerobic exercise for sport-
related concussion: a systematic review and meta-analysis. Med Sci Sports Exerc. 
2020;52(12):2491-2499. https://doi.org/10.1249/mss.0000000000002402.  

9. Ranns D, Valovich McLeod TC. Optimizing return to learn following a sport-related concussion: a 
quality improvement project. Clin Pract Athl Train. 2019;2(3):1-15. 
https://doi.org/10.31622/2019/0003.1.  

10. Stuart EA, Duerson DH, Rodenberg RE, Ravindran R, MacDonald JP. Return to drive counseling 
after sports-related concussion: a quality improvement project. Pediatr Qual Saf. 2016;1(2):e006. 
https://doi.org/10.1097%2Fpq9.0000000000000006.  

 

 

https://doi.org/10.1227/neu.0000000000001447
https://doi.org/10.1249/mss.0000000000002402
https://doi.org/10.31622/2019/0003.1
https://doi.org/10.1097%2Fpq9.0000000000000006

	ABSTRACT

