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Cognitive Rest AND Concussion

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https://www.readbyqxmd.com/read/27920269/same-care-different-populations-return-to-learn-practices-following-concussion-in-primary-and-secondary-schools
#1
Laura S Blackwell, Anna F Robinson, Mark R Proctor, Alex M Taylor
The authors conducted a cross-sectional survey of Massachusetts school nurses examining return-to-learn practices for children recovering from concussion in prekindergarten through high school. Regardless of school setting, all students received academic accommodations to support learning during recovery. School nurses perceived less benefit to prolonged cognitive rest (>4 days) for high school students relative to students in elementary school, but provided academic accommodations to them for comparatively longer periods of time (10-14 days vs 6-10 days)...
December 5, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27813685/physical-activity-and-intermittent-postconcussion-symptoms-after-a-period-of-symptom-limited-physical-and-cognitive-rest
#2
Quinton Sawyer, Brian Vesci, Tamara C Valovich McLeod
: Reference: Schneider KJ, Iverson GL, Emery CA, McCrory P, Herring SA, Meeuwisse WH. The effects of rest and treatment following sport-related concussion: a systematic review of the literature. Br J Sports Med. 2013;47(5):304-307. CLINICAL QUESTION: After concussion and a period of symptom-limited physical and cognitive rest, do athletes who experience intermittent symptoms return to asymptomatic condition more quickly with physical activity than with prolonged physical rest? DATA SOURCES: One investigator performed an individual search for each research question using the following databases: CINAHL, Cochrane Controlled Trials Registers, EMBASE, HealthSTAR, ProQuest, PsychInfo, PubMed, SPORTDiscus, and Web of Science...
September 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27792852/cognitive-rest-and-graduated-return-to-usual-activities-versus-usual-care-for-mild-traumatic-brain-injury-a-randomized-controlled-trial-of-emergency-department-discharge-instructions
#3
Catherine E Varner, Shelley McLeod, Negine Nahiddi, Rosamond E Lougheed, Taylor E Dear, Bjug Borgundvaag
INTRODUCTION: It is estimated 15-25% of patients with a mild traumatic brain injury (MTBI) diagnosed in the emergency department (ED) will develop post-concussive syndrome (PCS). The objective of this study was to determine if patients randomized to graduated return to usual activity discharge instructions had a decrease in their Post-Concussion Symptom Score (PCSS) 2 weeks after MTBI compared to patients who received usual care MTBI discharge instructions. METHODS: This was a pragmatic, randomized trial of adult (18-64 years) patients of an academic ED (annual census 60,000) diagnosed with MTBI occurring within 24 hours of ED visit...
October 28, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27762653/resting-state-magnetoencephalography-reveals-different-patterns-of-aberrant-functional-connectivity-in-combat-related-mild-traumatic-brain-injury
#4
Ming-Xiong Huang, Deborah L Harrington, Ashley Robb Swan, Annemarie Angeles Quinto, Sharon Nichols, Angela Drake, Tao Song, Mithun Diwakar, Charles W Huang, Victoria B Risbrough, Anders Dale, Hauke Bartsch, Scott Matthews, Jeffrey W Huang, Roland R Lee, Dewleen G Baker
Blast mild traumatic brain injury (mTBI) is a leading cause of sustained impairment in military service members and veterans. However, the mechanism of persistent disability is not fully understood. The present study investigated disturbances in brain functioning in mTBI participants using a source-imaging-based approach to analyze functional connectivity (FC) from resting-state magnetoencephalography (rs-MEG). Study participants included 26 active-duty service members or veterans who had blast mTBI with persistent post-concussive symptoms, and 22 healthy control active-duty service members or veterans...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27633028/cognitive-rest-following-concussions-rethinking-cognitive-rest
#5
Mark E Halstead, Brenda Eagan Brown, Karen McAvoy
No abstract text is available yet for this article.
September 15, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27632824/the-effect-of-cognitive-rest-as-part-of-post-concussion-management-for-adolescent-athletes-a-critically-appraised-topic
#6
Rachel S Johnson, Mia K Provenzano, Larynn M Shumaker, Tamara C Valovich-McLeod, Cailee E Welch Bacon
No abstract text is available yet for this article.
August 24, 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/27605923/multi-disciplinary-management-of-athletes-with-post-concussion-syndrome-an-evolving-pathophysiological-approach
#7
Michael J Ellis, John Leddy, Barry Willer
Historically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to school and sports activities in the majority of athletes, an important proportion will develop persistent concussion symptoms characteristic of post-concussion syndrome (PCS). Recent advances in exercise science, neuroimaging, and clinical research suggest that the clinical manifestations of PCS are mediated by unique pathophysiological processes that can be identified by features of the clinical history and physical examination as well as the use of graded aerobic treadmill testing...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27601433/a-comparison-of-psychiatric-and-nonpsychiatric-nurse-practitioner-knowledge-and-management-recommendations-regarding-adolescent-mild-traumatic-brain-injury
#8
Tracy A Klein, Janessa M Graves
BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs...
September 6, 2016: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/27581848/the-timing-of-cognitive-and-physical-rest-and-recovery-in-concussion
#9
Bruce Taubman, Florence Rosen, Jennifer McHugh, Matthew F Grady, Okan U Elci
Immediate cognitive and physical rest in the concussed patient is almost universally recommended in the concussion literature. The authors conducted a prospective observational in a primary care pediatric office to examine the effect of delayed cognitive and physical rest had on recovery time in pediatric concussion. The authors found that patients who started cognitive and physical rest immediately after injury were more likely to recover within 30 days compared to patients who delayed cognitive and physical rest for 1-7 days after their injury (67% vs 35%, P = ...
August 31, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27531393/evidence-of-alterations-in-transcallosal-motor-inhibition-as-a-possible-long-term-consequence-of-concussions-in-sports-a-transcranial-magnetic-stimulation-study
#10
Travis W Davidson, François Tremblay
OBJECTIVE: Growing evidence suggests that long-term structural and physiological alterations are present in the brain of previously concussed athletes. In this study, we sought to further explore the long-term consequences of concussions with transcranial magnetic stimulation (TMS) by examining excitability changes both within and between hemispheres. METHODS: Participants (32 young adults with and without a history of concussions (HxC)) first underwent testing to assess cognitive and motor performance using standardized tests...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27521273/reducing-the-time-interval-between-concussion-and-voluntary-exercise-restores-motor-impairment-short-term-memory-and-alterations-to-gene-expression
#11
Richelle Mychasiuk, Harleen Hehar, Irene Ma, Sydney Candy, Michael J Esser
Despite the most common form of brain injury, there has been little progress in the prognosis and treatment of concussion/mild traumatic brain injury (mTBI). Current 'return-to-play' guidelines are conservative, deterring the initiation of physical and social activity until patients are asymptomatic; but the effects of post-injury exercise have not been adequately investigated. Therefore, this study examined the effects of voluntary exercise on concussion recovery. Using a translational rodent model of concussion, we examined the influence of exercise on injury-associated behaviours that comprise post-concussive syndrome (PCS) and gene expression changes (bdnf, dnmt1, Igf-1, pgc1-a, Tert) in prefrontal cortex and hippocampus...
October 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/27455446/challenging-the-dogma-that-rest-is-best-after-concussion-commentary-on-mychasiuk-et-al
#12
Bridgette D Semple
No abstract text is available yet for this article.
October 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/27391530/near-point-of-convergence-after-concussion-in-children
#13
Eileen P Storey, Stephen R Master, Julia E Lockyer, Olivia E Podolak, Matthew F Grady, Christina L Master
PURPOSE: To determine the incidence of abnormal near point of convergence (NPC) after acute concussion in pediatric patients and to describe the clinical course of such patients. METHODS: A retrospective cohort study of 275 pediatric patients 5 to 18 years of age presenting to a tertiary care children's hospital subspecialty concussion program with a new concussion between July 1, 2014 and June 30, 2015 was conducted. RESULTS: Sixty-seven out of 275 pediatric patients presenting to a subspecialty concussion referral program were found to have abnormal NPC on physical examination as measured by an accommodative rule...
July 6, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/27303008/are-canadian-clinicians-providing-consistent-sport-related-concussion-management-advice
#14
James D Carson, Alexandra Rendely, Alisha Garel, Christopher Meaney, Jacqueline Stoller, Jatin Kaicker, Leigh Hayden, Rahim Moineddin, Pierre Frémont
OBJECTIVE: To compare the knowledge and use of recommendations for the management of sport-related concussion (SRC) among sport and exercise medicine physicians (SEMPs) and emergency department physicians (EDPs) to assess the success of SRC knowledge transfer across Canada. DESIGN: A self-administered, multiple-choice survey accessed via e-mail by SEMPs and EDPs. The survey had been assessed for content validity. SETTING: Canada. PARTICIPANTS: The survey was completed between May and July 2012 by SEMPs who had passed the diploma examination of the Canadian Academy of Sport and Exercise Medicine and by EDPs who did not hold this diploma...
June 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/27154855/active-rehabilitation-of-concussion-and-post-concussion-syndrome
#15
REVIEW
John J Leddy, John G Baker, Barry Willer
Concussion is a physiological brain injury with physical, cognitive, and emotional sequelae. The macrophysiological insult to the brain affects the autonomic nervous system and its control of cerebral blood flow. Most patients recover within 2 weeks, but some do not. Persistence of symptoms beyond the generally accepted time frame for recovery is called post-concussion syndrome (PCS). PCS is not a single entity; it is a group of disorders that requires specific forms of therapy. Rest has been the mainstay of the treatment for concussion and PCS...
May 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27031311/adolescent-concussion-and-return-to-learn
#16
Sabrina Santiago
Concussion is a common diagnosis in adolescents, particularly in those who play sports. Physical and cognitive rest is the mainstay of treatment. However, the guidelines for returning to full cognitive effort are more nebulous. This article examines the existing evidence on return-to-learn guidelines, and offers some ideas of school accommodations that can be made for students who have experienced a concussion. This article also reviews the situations in which it is recommended to seek guidance from a concussion specialist or sports medicine physician...
March 2016: Pediatric Annals
https://www.readbyqxmd.com/read/26972272/the-role-of-controlled-exercise-in-concussion-management
#17
REVIEW
John Leddy, Andrea Hinds, Dan Sirica, Barry Willer
Concussion affects the autonomic nervous system and its control of cerebral blood flow, which may be why uncontrolled activity can exacerbate symptoms after concussion. Traditionally, patients have been advised to restrict physical and cognitive activity until all symptoms resolve. However, recent research suggests that prolonged rest beyond the first couple of days after a concussion might hinder rather than aid recovery. Humans do not respond well to removal from their social and physical environments, and sustained rest adversely affects the physiology of concussion and can lead to physical deconditioning and reactive depression...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/26942658/examining-academic-support-after-concussion-for-the-adolescent-student-athlete-perspectives-of-the-athletic-trainer
#18
Tricia Kasamatsu, Michelle Cleary, Jason Bennett, Keith Howard, Tamara Valovich McLeod
CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion...
February 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/26919230/the-effect-of-cognitive-rest-as-part-of-post-concussion-management-for-adolescent-athletes-a-critically-appraised-topic
#19
Rachel S Johnson, Mia K Provenzano, Larynn M Shumaker, Tamara C Valovich-McLeod, Cailee E Welch Bacon
: Following concussion, it is hypothesized that cognitive activity may potentially hinder patient recovery. This is based on the theory that cognitive activity alters the metabolism of the brain, which could potentially delay the healing process of a traumatic brain injury. While the recommendation of cognitive rest is often maintained and rationalized, a causal relationship between cognitive activity and symptom duration has yet to be established. Symptom severity and duration is recorded and assessed using different outcome measurement tools such as the Post-Concussion Symptom Scale (PCSS)...
February 26, 2016: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/26900581/reduced-brain-connectivity-and-mental-flexibility-in-mild-traumatic-brain-injury
#20
Elizabeth W Pang, Benjamin T Dunkley, Sam M Doesburg, Leodante da Costa, Margot J Taylor
OBJECTIVE: A mild traumatic brain injury (mTBI), or concussion, has known neuropsychological sequelae, and neuroimaging shows disturbed brain connectivity during the resting state. We hypothesized that task-based functional connectivity measures, using magnetoencephalography (MEG), would better link the neurobiological underpinnings of cognitive deficits to specific brain damage. METHODS: We used a mental flexibility task in the MEG and compared brain connectivity between adults with and without mTBI...
February 2016: Annals of Clinical and Translational Neurology
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