Concussion

Question 1

sports related concussions per year

Answer 1

1.6 to 3.8 million

Question 2

MC Cause TBI/Concussion for younger & older

Answer 2

FALL

Question 3

standard medical imaging findings for Concussion:

Answer 3

• often unremarkable
• indicated to rule out more serious conditions/subdural hematoma

Question 4

Concussion Symptoms

Answer 4

headache
dizziness
nausea/vomiting
imbalance
vision changes: blurry, double, eye pain/strain
fatigue
sleep cycle changes
light sensitivity
sound sensitivity
impaired concenteration
impaired memory
fogginess
mood changes: irritability, sadness, labile

Question 5

Typical Concussion recovery period

Answer 5

21-28 days, beyond that time frame is protracted recovery

Question 6

Concussion Treatment

Answer 6

individualized/ no one size fits all, engage a multidisciplinary team
use symptoms as a guide to determine exercise levels and intensity
education: sleep regulation, migraine prevention, cognitive energy conservation, daily physical activity/exercise

vestibular rehabilitation
vision therapy/orthoptics
rest (but not prolonged strict rest)
medication
education/trigger modification
relaxation
biofeedback
Exercise- jury still out
manual therapy
injection
acupuncture
CBT
psycotherapy
self-help/support groups

Question 7

Evidence on rest and concussion

Answer 7

limited evidence that prescribed rest reduces symptoms for ALL individual following concussion

evidence for active approaches for recovery exist for the associated impairments and symptoms

for protracted recovery, exercise is both SAFE and EFFECTIVE

Question 8

6 Clinical Concussion Symptom profiles

Answer 8

post-traumatic migraine headache
vestibular: dizziness, nausea
ocular
cognitive/fatigue
anxiety/mood
cervical
other: sleep, cardiovascular

Question 9

2 tools that can be useful if a concussion is suspected

Answer 9

Post-Concussion Symptom Scale (PCSS)
self-report symptom checklist
7 point scale (0-6) that asks individuals to rank common symptoms following concussion
domains addressed: physical, cognitive, sleep, affective

Vestibular-Oculomotor Screen (VOMS)
-assessment of vestibular & oculomotor systems: smooth pursuits, saccades, convergence, vestibulo-ocular reflex, visual motion sensitivity

baseline symptoms 0-10 and symptoms with each activity focusing on changes in symptoms

strong internal consistency, correlated with PCSS