final exam concussion interventions

Question 1

common symptom complaints of concussion

Answer 1

headache
dizziness
nausea
poor balance
fatigue
disruption of sleep
visual deficits
fogginess
emotional lability
noise & light sensitivity
poor concentration
memory impairments
neck pain

Question 2

what is the best practice standards for ages 8 and older post concussion?
- first 24-48 hours?
- after 48-72 hours?

Answer 2

• rest
• initiate light activity based on tolerance

Question 3

during the acute phase what should you do?

Answer 3

avoid extremes (i.e., strict rest, intense cognitive or physical activity)
relative rest
promote gradual return to activity

Question 4

what are the 5 primary domains for intervention?

Answer 4

exertional tolerance and aerobic
cervical MSK
vestibular-oculomotor
motor function
education

Question 5

exertional tolerance and aerobic intervention:
- grade ___
- implement ___
- exhibit ____

Answer 5

• Grade level A
• symptom-guided, progressive aerobic exercise training program
• exertional intolerance

Question 6

exercise prescription for concussion is based on _______. recommendation is to exercise below ___% HR threshold for _____ minutes daily

Answer 6

exertional testing (buffalo concussion test)
90%
20-30 min/day

Question 7

progression for exercise prescription:
may increase HR by ____ bpm every ____ weeks.
- no new ___
- mild increase in symptoms that is _____ in nature
- goal is to ___

Answer 7

5-10 bpm every 1-2 weeks
- symptoms
- transient
- reach APMHR for 20 minutes without symptom exacerbation

Question 8

cervical MSK:
- grade level ___
- implement:

Answer 8

• B
• interventions that aim to address cervical and thoracic spine dysfunction

Question 9

cervical spine dysfunction can contribute to:
- treatment options?

Answer 9

headaches, dizziness, TMJ disorder
- MT, dry needling, modalities, stretching/postural control exercises, cervical kinesthesia exercises

Question 10

vestibular-oculomotor interventions:
- if BPPV is identified as potential impairment
— grade?
— use ____ for intervention

Answer 10

• A
• canalith repositioning interventions

Question 11

vestibular-oculomotor interventions:
- exhibit vestibular and/or oculomotor dysfunction:
— Grade level __
— implement ______

Answer 11

• B
• individualized vestibular and oculomotor rehabilitation plan

Question 12

for patients who experienced post-head trauma, BPPV can occur. what are some treatment considerations?

Answer 12

cervical pain and/or limitations with ROM
** treat the one that is most symptomatic first (think which will reduce symptoms fast)

Question 13

what are some convergence insufficiency exercises?

Answer 13

brock string
dot card
pencil push up
shuttle pass
barrel cards

Question 14

what are some oculomotor exercises?

Answer 14

marsden ball (pursuits)
michigan tracking (saccades)
column jumps (saccades)
HART chart (saccades)

Question 15

with convergence insufficiency and oculomotor exercises what should you monitor for?

Answer 15

headaches

Question 16

moderate to severe oculomotor abnormalities should be referred to _____
- what are examples of these type of abnormalities?

Answer 16

vision specialist or OT
- ocular misalignment, diplopia, >1 month since onset

Question 17

what are vestibular-oculomotor exercise progressions?

Answer 17

seated –> standing
wide –> narrow BOS
sitting –> standing
firm –> compliant surface
simple –> complex background
addition of cognitive task
increase reps and speed of movement

Question 18

motor function intervention:
- grade ___
- implement:

Answer 18

• C
• interventions that address identified or suspected motor function impairments and help progress the patient towards higher-level functional performance goals

Question 19

studies have shown that athletes who have suffered a concussion exhibit _______ in comparison to age matched controls

Answer 19

slower gait speeds when doing a dual task assessment

Question 20

communication and education:
- for patient education:
— Grade __
— interventions:

Answer 20

• B
• self-management of symptoms
• relative rest vs. strict rest
• importance of sleep
• pacing strategies
• S&S may require additional medical care

Question 21

communication and education:
- for patient and family/caregivers education:
— Grade ___
— interventions:

Answer 21

— A
— impairments, functional limitations, reinforce that most people have a quick recovery

Question 22

treatment considerations:

Answer 22

environment (light and noise sensitivity, emotional lability)
pacing of session (symptom irritability and recovery time)
time of day
age (across the lifespan)
fall risk

Question 23

timeline of recovery:
1. symptom management

Answer 23

management of symptoms
education
subsymptom threshold exercises

Question 24

timeline of recovery:
2. movement system optimization

Answer 24

exercise
individualized visual motion habituation
mobility and postural control normalization

Question 25

timeline of recovery:
3. performance optimization

Answer 25

specific conditioning
functional activity training

Question 26

most students will only need _____ accommodations as they recover.
students with persistent concussion symptoms will need _____
– examples?

Answer 26

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

Question 27

what is the goal for return to work?
what are some challenges?

Answer 27

return to work without negatively impacting concussion recovery
- background noise, multiple screens, overhead lighting, multi-tasking

Question 28

example accommodations for return to work?

Answer 28

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