mTBI and concussion considerations

Question 1

Cognitive symptoms of a concussion

Answer 1

concentration, distractible, memory, cognitive fatigue

Question 2

mood disruption symptoms of a concussion

Answer 2

irritability, depression, anxiety, panic

Question 3

sleep symptoms of a concussion

Answer 3

difficulty falling asleep, exessive sleep, fragmented sleep

Question 4

somatic symptoms of a concussion

Answer 4

headache, dizziness, visual disturbances, impaired balance, nausea, light/noise sensitivity, cervical pain

Question 5

risk factors for longer recovery

Answer 5

female, history of TBI, history of migraines, impaired cognition or behavioral changes, athletes

Question 6

on-field symptoms for longer recovery

Answer 6

posttraumatic migraines, LOC, dizziness/fogginess, cognitive deficits with first few days, severity of second injury

Question 7

Day of injury RTP

Answer 7

-rest for 24-48h, physical and cognitive
-no return if a concussion is suspected
-monitor symptoms for 24-48h

Question 8

when to advance the activity

Answer 8

-asymptomatic for 24h
-phases last 24h
-if symptoms happen, stop, return to the previous phase

Question 9

baseline data includes:

Answer 9

neurological, cognitive, balance/motor screens and coordination, visual and ocular motor

Question 10

phase 1: rest, no activity

Answer 10

-physical and cognitive rest until 24h w/out symptoms
goals: eliminate symptoms, heal brain

Question 11

Phase 2: light aerobic

Answer 11

-walking at home or on the field, or stationary biking
-intensity= <70% HR
-no resistant training, lifting, jumping, or hard running
goals: increase HR to connect symptoms
2 sessions at each level
15min @100-120bpm
30min @100-120bpm
30min @ 140bpm

Question 12

phase 3: moderate aerobic, light resistance

Answer 12

-20-30min jogging
-resistance training with body weight only
goals: continued increase in HR and conditioning

Question 13

Phase 4: sport-specific, multi-planar

Answer 13

-skating drills for hockey, running drills for soccer, moderate jogging, brief running, moderate-intensity cycling
-no head impact activities, limited head movt
goals: added movements in multiple planes and directions, introduce to rotational forces

Question 14

phase 5: non-contact training

Answer 14

-resistance training
-sport-specific drills with no contact
Goals: exercise, coordination, and cognitive load. increase intensity, maximise aerobic activity, full speed w/changes in direction

Question 15

phase 6: light contact

Answer 15

-same intensity with equipment or gear, no full play
Goals: add deceleration and rotational activities with increased speed and abrupt changes in speed and direction

Question 16

phase 7: practice, full court

Answer 16

-following medical clearence= normal training
-no competition
goals: restore confidence and skills

Question 17

phase 8: competition

Answer 17

-normal game play
goals: continue to monitor in game