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Frémont, Pierre

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Frémont

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Pierre

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Université Laval. Département de réadaptation

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ncf10316730

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Are Canadian clinicians providing consistent sport-related concussion management advice?

2016-06-01, Carson, James D., Frémont, Pierre, Rendely, Alexandra, Garel, Alisha, Meaney, Christopher, Stoller, Jacqueline, Kaicker, Jatin, Hayden, Leigh, Moineddin, Rahim

Objective: To compare the knowledge and use of recommendations for the management of sport-related concussion (SRC) among sport and exercise medicine physicians (SEMPs) and emergency department physicians (EDPs) to assess the success of SRC knowledge transfer across Canada. Design: A self-administered, multiple-choice survey accessed via e-mail by SEMPs and EDPs. The survey had been assessed for content validity. Setting: Canada. Participants: The survey was completed between May and July 2012 by SEMPs who had passed the diploma examination of the Canadian Academy of Sport and Exercise Medicine and by EDPs who did not hold this diploma. Main outcome measures: Knowledge and identification of sources of concussion management information, use of concussion diagnosis strategies, and whether physicians use common and consistent terminology when explaining cognitive rest strategies to patients after an SRC. Results: There was a response rate of 28% (305 of 1085). The SEMP and EDP response rates were 41% (147 of 360) and 22% (158 of 725), respectively. Of the responses, 41% of EDPs and 3% of SEMPs were unaware of any consensus statements on concussion in sport; 74% of SEMPs used the Sport Concussion Assessment Tool, version 2 (SCAT2), “usually or always,” whereas 88% of EDPs never used the SCAT2. When queried about how cognitive rest could best be achieved after an SRC, no consistent answer was documented. Conclusion: Differences and a lack of consistency in the implementation of recommendations for SRC patients were identified for SEMPs and EDPs. It appears that the SCAT2 is used more in the SEMP setting than in the emergency context. Further knowledge transfer efforts and research should address the barriers to achieving more consistent advice given by physicians who attend SRC patients.

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Recommendations for policy development regarding sport-related concussion prevention and management in Canada

2014-07-12, Frémont, Pierre, Bradley, Lindsay, Tator, Charles H., Skinner, Jill, Fischer, Lisa K.

The Canadian Concussion Collaborative (CCC) is composed of health-related organisations concerned with the recognition, treatment and management of concussion. Its mission is to create synergy between organisations concerned with concussion to improve education and implementation of best practices for the prevention and management of concussions. Each of the organisations that constitute the CCC has endorsed two recommendations that address the need for relevant authorities to develop policies about concussion management in sports. The recommendations were developed to support advocacy for regulations, policies or legislation to improve concussion prevention and management at all levels of sport.

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Physical activity prescription : a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease : a position statement by the Canadian Academy of Sport and Exercise Medicine

2016-06-22, Thornton, Jane S., Frémont, Pierre, Poirier, Paul, Khan, Karim, Fowles, Jonathon, Wells, Greg D., Frankovich, Renata J

Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.