Concussion Flashcards
T or F: Concussions often have normal imaging
T
Should patients w/ concussion have absolute rest?
No
If a pt is feeling normal after 6-7 days does this mean that their brain is back to normal
No
how much force normally causes a concussion
what kind of force most commonly causes a concussion
70-120g or 5582-9515 rad of rotational force
concussions are most commonly caused by rotational force
T or F: the majority of impacts we see in football and the majority of headers in soccer are less than what is required to cause a concussion
T
What is the criteria for a concussion
what is the most common symptom?
MOI, 1 symptom present
Most common somatic: headache
most common cognitive: feeling slowed down
What should you do first for a player that has sustained a concussion on the field
clear cervical spine and VBI
perform CN tests if indicated
Concussion red flags
Neck pain or tenderness
seizure or convulsion
double vision
loss of consciousness
weakness or tingling/burning in more than 1 arm and leg
deteriorating conciousness
vomiting
severe or increasing headache
increasing restlessness, agitation
GCS < 15
Visible deformity of skull
What is the criteria for Persistent concussion symptoms
More than 3 persistent symptoms AT REST
30 or more days following a concussion
What are the 3 causes of persistent concussion syndrome
- autonomic dysregulation
- inflammation (gut-brain axis)
- visual/vestibular/cervical
How do we treat inflammation due to the gut-brain axis in concussion
diet recommendations
they need water, protein, healthy fats
dont restrict calories
Avoid: Caffeine and alcohol, processed foods, artificial sweeteners, fad diets
T or F: When we are administering a test to a player on the field, or in a follow up, we should let them know they might score poorly on this since they have a concussion
F, don’t tell patients that theyll do poorly, instead encourage them to do well
Patients with ____________ have a lower risk of post concussion syndrome than those without
early physical activity
What is second impact syndrome
2nd concussion occurs before the 1st concussion has properly healing
Second concussion syndrome happens most often in
athletes under 21
What are signs second impact syndrome
Catastrophic increase in intracranial pressure causes:
Dilated pupils
Loss of eye movement
unconsciousness
Respiratory failure
death
Day 1 of treating a concussion consists of
Baseline testing
assessment
treatment
education
What kind of foods do people with concussions need to eat?
omega 3 fatty acids
protein
need to eat atleast half the number of calories
NO FAD DIETS `
How much water is recommended for after a concussion per day
.5 oz for every lb of bodyweight
What foods should someone with a concussion avoid
Caffine/alcohol
sugar/processed foods
artificial sweeteners
fad diets
What kind of nutritional habits help w/ concussion
eat smaller meals more frequently
emphasize moderation and variety
At what day post-concussion should a person do the BCTT
day 2
What are the contraindications of BCTT
Electrolyte imbalance
Extreme hypertension 200/110
arrythmias
most bad sounding cardiac conditions
On a scale of 0-10, their symptoms must be under ______ to do the BCTT
6/10 or less
7/10 do not do BCTT
The warm up speed for the BCTT is ________
How does it increase
2.5mph with 0% incline for 2 mins for warmup
official test starts at 3.3 with 0% incline
increase incline by 1% every minute for 15 mins
what is the failing criteria of the BCTT
worsening of overall wellbeing score by 3 or more points
what is the passing criteria of the BCTT
Pt reaches their age adjusted max HR
(220-age) or reaches max exertion before symptoms increase by 3/10
When perscribing an exercise protocol for concussion, make sure the patient is exercising atleast ______________ a week for ___________ minutes at a rate of __________________
5 times a week
20-30 mins
at 80-90% of their symptom threshold
Workouts should be _____________ compared to the symptom threshold
Athletes:
Non-Athletes:
80-90%
Athletes: 90%
non-athletes: 80%
What is performed on day 3 of concussion
Cervical and VOMS testing
How is VOMS tested in concussion and what is considered positive
Rate symptoms (headache, dizziness, nausea, fogginess) each gets a score of 1-10 for each activity
Smooth pursuit
Saccades- horizontal
Saccades - vertical
Convergence
VOR horizontal
VOR vertical
Visual motion sensitivity
SCORE OF GREATER THAN 2 IS POSITIVE
for VOMS testing, a score of __________ out of 10 is considered positive for any component of the test
2
How can a PT likely improve attention and cognition in concussion patients
by addressing VOMS/vision deficits
T or F: to test vergence, we measure the distance to which the patient experienced blurriness
F, double vision
How many times do we repeat the convergence test
3 times, middle, high, and low
Pt reports difficulty in cars, busy events, what part of VOMS do they likely need to work on
VORC visual motion sensitivity
