Concussion Management in Equestrian Athletes: A Cross Sectional Survey of SCAT6 Data

Authors

Nicole Scarpino, Nova Southeastern UniversityFollow
Kerstin Palombaro, Widener University - Main CampusFollow
Annette M. Willgens, Nova Southeastern UniversityFollow

Abstract

Purpose: The purpose of this study was to describe concussion symptomatology, frequency, and management by equestrian athletes. Although the International Equestrian Federation (FEI.org) and the United States Equestrian Federation (USEF.org) have implemented new Return to Sport Strategies, it is unknown how equestrian athletes manage concussion symptoms and whether more robust recommendations are warranted. Methods: A Qualtrics survey was used to collect data from January 1 to February 1, 2025. It was posted on equestrian Facebook groups to target athletes who practiced their sport more than 3 times per week in 1 of 3 disciplines. Respondents reported falls from a horse over the past 2 years and completed sections of the Sport Concussion Assessment Tool 6 (SCAT6). Results: There were 216 respondents and 164 met all 3 inclusion criteria. Of the 164 participants, 119 completed the survey in its entirety. Results indicated that equestrian athletes were not formally evaluated by a medical professional after falling, returned to riding without evaluation, and did not address concussive symptoms with physical therapy (PT). Nine participants completed a baseline concussion test. Headache, neck pain, don’t feel right, and fatigue were the more severely rated symptoms at days 0-3 that persisted to 1 month based on the SCAT6. Of the 31 athletes who lost consciousness, 22 were not reassessed by a medical provider and only 7 attended PT. Of the 31 athletes who lost consciousness, 3 did not seek medical attention at the time of injury. Conclusion: More comprehensive, large-scale recommendations are lacking in the equestrian industry. These data produce 9 recommendations that enlist stakeholders to act at every level of the sport. Recommendations include improved concussion awareness and reporting of falls, benefits of PT for baseline testing, preventative exercise, onsite evaluation, and early rehabilitation.

Author Bio(s)

Nicole Scarpino, MS, SPT, is a final year Doctor of Physical Therapy Student in the Dr. Pallavi Patel College of Health Care Sciences at Nova Southeastern University in Tampa, Florida. She is an equestrian athlete and will serve the equestrian community as a physical therapist.

Dr. Kerstin Palombaro, PT, PhD, CAPS, is a professor and program director for the PhD Program in Health Professions Education at Widener University. She is passionate about community engagement, community-based global learning, and research.

Annette M. Willgens, PT, MS, EdD, is a professor in the Doctor of Physical Therapy Program in the Dr. Kiran C. Patel College of Osteopathic Medicine, School of Rehabilitation Sciences at Nova Southeastern University in Tampa, Florida. She is an equestrian athlete, pediatric physical therapist, and researcher.

Acknowledgements

We honor the athletes who shared their concussion experiences with us and wish them health and wellness now and in the future.

Recommended Citation

Scarpino N, Palombaro K, Willgens AM. Concussion Management in Equestrian Athletes: A Cross Sectional Survey of SCAT6 Data. The Internet Journal of Allied Health Sciences and Practice. 2025 Oct 15;23(4), Article 15.