A cross-sectional study examining Nigerian footballers’ knowledge and attitudes towards sport-related concussion

Introduction and purpose: Understanding concussion knowledge and attitudes has become an area of interest within football, though this is mostly limited to the Western World. Little evidence is currently available in Nigeria despite having the highest number of active football players in Africa. Due to this lack of insight and difficulties extrapolating findings from other populations due to contextual and cultural differences, the purpose of this study was to assess Nigerian footballers’ knowledge and attitudes towards concussions and determine the impact of several contextual factors. Materials and Methods: A cross-sectional study design was used with an online questionnaire distributed to Nigerian footballers. The questionnaire included participant characteristics and the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS). The concussion knowledge index (CKI, 0-25) and attitude index (CAI, 15-75) were calculated. The association between various contextual factors with “high” knowledge and attitude were determined using univariable and multivariable logistic regression. Results: In total, 331 responses were received reflecting 10 clubs. Mean CKI and CAI scores were 14.0±3.0 (56.2±13.2%) and 54.5±9.4 (72.6±12.5%), respectively. A small proportion (n=25; 8%) of participants reported a previously diagnosis of an SRC, with a further 40 (12%) suspecting they have suffered SRC. Thirty-five participants (11%) reported sustaining a SRC but did not seek medical help. Men were at 4.8 times greater odds of having a “high[er]” CKI than women, and that those with 5-10 years playing experience had lower odds of a “high” CKI than those with >10 years’ experience. Men had 7 times greater odds of having a “high” CAI than women. Conclusion: The results of this study suggest that Nigerian footballers have moderate concussion knowledge, satisfactory symptom recognition, and good attitudes. Those working with Nigerian footballers may consider these findings when striving to improve concussion knowledge, potentially by improving attitudes, and considering sex and playing experience