final exam concussion interventions Flashcards
common symptom complaints of concussion
headache
dizziness
nausea
poor balance
fatigue
disruption of sleep
visual deficits
fogginess
emotional lability
noise & light sensitivity
poor concentration
memory impairments
neck pain
what is the best practice standards for ages 8 and older post concussion?
- first 24-48 hours?
- after 48-72 hours?
- rest
- initiate light activity based on tolerance
during the acute phase what should you do?
avoid extremes (i.e., strict rest, intense cognitive or physical activity)
relative rest
promote gradual return to activity
what are the 5 primary domains for intervention?
exertional tolerance and aerobic
cervical MSK
vestibular-oculomotor
motor function
education
exertional tolerance and aerobic intervention:
- grade ___
- implement ___
- exhibit ____
- Grade level A
- symptom-guided, progressive aerobic exercise training program
- exertional intolerance
exercise prescription for concussion is based on _______. recommendation is to exercise below ___% HR threshold for _____ minutes daily
exertional testing (buffalo concussion test)
90%
20-30 min/day
progression for exercise prescription:
may increase HR by ____ bpm every ____ weeks.
- no new ___
- mild increase in symptoms that is _____ in nature
- goal is to ___
5-10 bpm every 1-2 weeks
- symptoms
- transient
- reach APMHR for 20 minutes without symptom exacerbation
cervical MSK:
- grade level ___
- implement:
- B
- interventions that aim to address cervical and thoracic spine dysfunction
cervical spine dysfunction can contribute to:
- treatment options?
headaches, dizziness, TMJ disorder
- MT, dry needling, modalities, stretching/postural control exercises, cervical kinesthesia exercises
vestibular-oculomotor interventions:
- if BPPV is identified as potential impairment
— grade?
— use ____ for intervention
- A
- canalith repositioning interventions
vestibular-oculomotor interventions:
- exhibit vestibular and/or oculomotor dysfunction:
— Grade level __
— implement ______
- B
- individualized vestibular and oculomotor rehabilitation plan
for patients who experienced post-head trauma, BPPV can occur. what are some treatment considerations?
cervical pain and/or limitations with ROM
** treat the one that is most symptomatic first (think which will reduce symptoms fast)
what are some convergence insufficiency exercises?
brock string
dot card
pencil push up
shuttle pass
barrel cards
what are some oculomotor exercises?
marsden ball (pursuits)
michigan tracking (saccades)
column jumps (saccades)
HART chart (saccades)
with convergence insufficiency and oculomotor exercises what should you monitor for?
headaches
moderate to severe oculomotor abnormalities should be referred to _____
- what are examples of these type of abnormalities?
vision specialist or OT
- ocular misalignment, diplopia, >1 month since onset
what are vestibular-oculomotor exercise progressions?
seated –> standing
wide –> narrow BOS
sitting –> standing
firm –> compliant surface
simple –> complex background
addition of cognitive task
increase reps and speed of movement
motor function intervention:
- grade ___
- implement:
- C
- interventions that address identified or suspected motor function impairments and help progress the patient towards higher-level functional performance goals
studies have shown that athletes who have suffered a concussion exhibit _______ in comparison to age matched controls
slower gait speeds when doing a dual task assessment
communication and education:
- for patient education:
— Grade __
— interventions:
- B
- self-management of symptoms
- relative rest vs. strict rest
- importance of sleep
- pacing strategies
- S&S may require additional medical care
communication and education:
- for patient and family/caregivers education:
— Grade ___
— interventions:
— A
— impairments, functional limitations, reinforce that most people have a quick recovery
treatment considerations:
environment (light and noise sensitivity, emotional lability)
pacing of session (symptom irritability and recovery time)
time of day
age (across the lifespan)
fall risk
timeline of recovery:
1. symptom management
management of symptoms
education
subsymptom threshold exercises
timeline of recovery:
2. movement system optimization
exercise
individualized visual motion habituation
mobility and postural control normalization
timeline of recovery:
3. performance optimization
specific conditioning
functional activity training
most students will only need _____ accommodations as they recover.
students with persistent concussion symptoms will need _____
– examples?
informal
formal support services:
- response to intervention protocol
- 504 plan
- individualized education plan (IEP)
- examples: note taker, sit in front of class, excused absence from school, quiet environment for testing, additional time for testing
what is the goal for return to work?
what are some challenges?
return to work without negatively impacting concussion recovery
- background noise, multiple screens, overhead lighting, multi-tasking
example accommodations for return to work?
avoid working directly under florescent light
allowed scheduled breaks or breaks before you become symptomatic
hour reduction/flexible hours
WFH
additional time for task completion
quiet work environment
