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concussion rehabilitation

Alan J Pearce, Janet A Young, Lucy Parrington, Nicole Aimers
The objective of this study was to explore beliefs and attitudes of students studying exercise science in Australia towards sports concussion. A secondary objective explored differences between gender and previous experience of concussion. A total of 312 participants (m = 217; f = 95) responded to a series of statements ranging across a number of areas including personal attitudes and beliefs towards concussion: if they would risk playing with a concussion; their views on elite/professional athletes who continue to play after a concussion; and attitudes towards rehabilitation...
October 18, 2016: Journal of Sports Sciences
Michael W Collins, Anthony P Kontos, David O Okonkwo, Jon Almquist, Julian Bailes, Mark Barisa, Jeffrey Bazarian, O Josh Bloom, David Brody, Robert Cantu, Javier Cardenas, Jay Clugston, Randall Cohen, Ruben Echemendia, R J Elbin, Richard Ellenbogen, Janna Fonseca, Gerard Gioia, Kevin Guskiewicz, Robert Heyer, Gillian Hotz, Grant L Iverson, Barry Jordan, Geoffrey Manley, Joseph Maroon, Thomas McAllister, Michael McCrea, Anne Mucha, Elizabeth Pieroth, Kenneth Podell, Matthew Pombo, Teena Shetty, Allen Sills, Gary Solomon, Danny G Thomas, Tamara C Valovich McLeod, Tony Yates, Ross Zafonte
BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion...
October 12, 2016: Neurosurgery
Michael J Ellis, Dean M Cordingley, Sara Vis, Karen M Reimer, Jeff Leiter, Kelly Russell
OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015...
September 30, 2016: Journal of Neurosurgery. Pediatrics
Patrick Grabowski, John Wilson, Alyssa Walker, Dan Enz, Sijian Wang
OBJECTIVE: Demonstrate implementation, safety and feasibility of multimodal, impairment-based physical therapy (PT) combining vestibular/oculomotor and cervical rehabilitation with sub-symptom threshold exercise for the treatment of patients with post-concussion syndrome (PCS). SETTING: University hospital outpatient sports medicine facility. PARTICIPANTS: Twenty-five patients (12-20 years old) meeting World Health Organization criteria for PCS following sport-related concussion referred for supervised PT consisting of sub-symptom cardiovascular exercise, vestibular/oculomotor and cervical spine rehabilitation...
June 7, 2016: Physical Therapy in Sport
A J Gardner, R Zafonte
Traumatic brain injury (TBI) is a significant public-health concern. TBI is defined as an acute brain injury resulting from mechanical energy to the head from external physical forces. Some of the leading causes of TBI include falls, assaults, motor vehicle or traffic accidents, and sport-related concussion. Two of the most common identified risk factors are sex (males are nearly three times more likely to suffer a TBI than females); and a bimodal age pattern (persons 65 years and older, and children under 14 years old)...
2016: Handbook of Clinical Neurology
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
Anne W Hunt, Luciano De Feo, Jennifer Macintyre, Dayna Greenspoon, Talia Dick, Katherine Mah, Melissa Paniccia, Christine Provvidenza, Nick Reed
BACKGROUND: Concussion is a considerable public health problem in youth. However, identifying, understanding and implementing best evidence informed recovery guidelines may be challenging for families given the vast amount of information available in the public domains (e.g. Internet). The objective of this study was to develop, implement and evaluate the feasibility of an evidence-informed self-management education program for concussion recovery in youth. METHODS: Synthesis of best evidence, principles of knowledge translation and exchange, and expert opinion were integrated within a self-management program framework to develop a comprehensive curriculum...
2016: BMC Health Services Research
Bridgette D Semple
No abstract text is available yet for this article.
October 2016: European Journal of Neuroscience
Amir Hadanny, Shai Efrati
Persistent post-concussion syndrome caused by mild traumatic brain injury has become a major cause of morbidity and poor quality of life. Unlike the acute care of concussion, there is no consensus for treatment of chronic symptoms. Moreover, most of the pharmacologic and non-pharmacologic treatments have failed to demonstrate significant efficacy on both the clinical symptoms as well as the pathophysiologic cascade responsible for the permanent brain injury. This article reviews the pathophysiology of PCS, the diagnostic tools and criteria, the current available treatments including pharmacotherapy and different cognitive rehabilitation programs, and promising new treatment directions...
August 2016: Expert Review of Neurotherapeutics
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
Brad G Kurowski, Jason Hugentobler, Catherine Quatman-Yates, Jennifer Taylor, Paul J Gubanich, Mekibib Altaye, Shari L Wade
OBJECTIVE: To describe the methodology and report primary outcomes of an exploratory randomized clinical trial (RCT) of aerobic training for management of prolonged symptoms after a mild traumatic brain injury (mTBI) in adolescents. SETTING: Outpatient research setting. PARTICIPANTS: Thirty adolescents between the ages of 12 and 17 years who sustained a mTBI and had between 4 and 16 weeks of persistent symptoms. DESIGN: Partially blinded, pilot RCT of subsymptom exacerbation aerobic training compared with a full-body stretching program...
April 26, 2016: Journal of Head Trauma Rehabilitation
McKay Moore Sohlberg, Alexander K Ledbetter
PURPOSE: This case review examines treatments speech-language pathologists at our clinic delivered to middle school, high school, and college students for the management of persistent cognitive symptoms after sport-related concussion. The goal is to examine a range of treatment options, describe clinical rationale for selecting those treatments, and report outcomes in order to identify feasible interventions for systematic evaluation through efficacy research. METHOD: Review of clinic intake data identified 63 cases referred for cognitive rehabilitation over a 36-month period...
May 1, 2016: American Journal of Speech-language Pathology
Charles Dillard, Nicole Ditchman, Karine Nersessova, Nicola Foster, Paul Wehman, Michael West, Brendalin Riedlinger, Eugenio Monasterio, Bill Shaw, Julie Neblett
Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children's Hospital of Richmond's TBI outpatient programme were analysed (N = 157)...
March 13, 2016: Disability and Rehabilitation
Mark S Rosner, Debby L Feinberg, Jennifer E Doble, Arthur J Rosner
PRIMARY OBJECTIVE: To examine the effectiveness of neutralizing prismatic lenses for reduction of headache, dizziness and anxiety in patients with persistent post-concussive symptoms and vertical heterophoria (VH). BACKGROUND: Approximately 5-10% of patients with traumatic brain injury (TBI) develop persistent post-concussive symptoms. Many rehabilitation/treatment modalities are tried, but are largely unsuccessful, indicating a need for more effective treatment...
2016: Brain Injury: [BI]
Tatyana Mollayeva, Brandy Pratt, Shirin Mollayeva, Colin M Shapiro, J David Cassidy, Angela Colantonio
AIM/BACKGROUND: The principal aim of this study was to, for the first time, examine the relationship between insomnia and perceived disability among workers with mild traumatic brain injury (mTBI)/concussion. PATIENTS/METHODS: A cross-sectional study was conducted at the Workplace Safety and Insurance Board Clinic of the largest rehabilitation teaching hospital in Canada. Data from questionnaires, insurer records and clinical investigations were analysed. The Insomnia Severity Index measured the primary independent variable, and the Sheehan Disability Scale measured disability outcomes, classified as 'mild/moderate' or 'marked/extreme'...
April 2016: Sleep Medicine
Katie L Scott, Carrie-Ann H Strong, Bethany Gorter, Jacobus Donders
OBJECTIVE: To determine factors related to three-month follow-up outcomes for individuals participating in an outpatient rehabilitative treatment program for mild traumatic brain injury (TBI). METHOD: Fifty participants underwent neuropsychological screening prior to treatment initiation and completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) at treatment initiation, discharge from treatment, and three months following discharge. RESULTS: Regression models indicated that information garnered from the neuropsychological screening prior to treatment initiation (e...
2016: Clinical Neuropsychologist
Matthew Cross, Simon Kemp, Andrew Smith, Grant Trewartha, Keith Stokes
AIM: To investigate incidence of concussion, clinical outcomes and subsequent injury risk following concussion. METHODS: In a two-season (2012/2013, 2013/2014) prospective cohort study, incidence of diagnosed match concussions (injuries/1000 h), median time interval to subsequent injury of any type (survival time) and time spent at each stage of the graduated return to play pathway were determined in 810 professional Rugby Union players (1176 player seasons). RESULTS: Match concussion incidence was 8...
August 2016: British Journal of Sports Medicine
Heidi Losoi, Noah D Silverberg, Minna Wäljas, Senni Turunen, Eija Rosti-Otajärvi, Mika Helminen, Teemu M Luoto, Juhani Julkunen, Juha Öhman, Grant L Iverson
This prospective longitudinal study reports recovery from mild traumatic brain injury (MTBI) across multiple domains in a carefully selected consecutive sample of 74 previously healthy adults. The patients with MTBI and 40 orthopedic controls (i.e., ankle injuries) completed assessments at 1, 6, and 12 months after injury. Outcome measures included cognition, post-concussion symptoms, depression, traumatic stress, quality of life, satisfaction with life, resilience, and return to work. Patients with MTBI reported more post-concussion symptoms and fatigue than the controls at the beginning of recovery, but by 6 months after injury, did not differ as a group from nonhead injury trauma controls on cognition, fatigue, or mental health, and by 12 months, their level of post-concussion symptoms and quality of life was similar to that of controls...
April 15, 2016: Journal of Neurotrauma
Suzanne Barker-Collo, Kelly Jones, Alice Theadom, Nicola Starkey, Anthony Dowell, Kathryn McPherson, Shanthi Ameratunga, Margaret Dudley, Braden Te Ao, Valery Feigin
OBJECTIVE: The relationship between moderate/severe traumatic brain injury (TBI) and cognitive deficits is well known. The nature, duration and predictors of cognitive difficulties post-mild TBI remain unclear. This study examined cognitive, mood and post-concussion outcomes of mild TBI over 1-year post-injury. METHOD: Adults (>15 years) with mild TBI (n = 260) completed neuropsychological (CNS-Vital Signs, Behavioural Dyscontrol Scale), mood (Hospital Anxiety Depression Scale) and behavioural assessments (Cognitive Failures Questionnaire, Rivermead Post-Concussion Questionnaire) at baseline, 1-, 6- and 12-months post-injury...
2015: Brain Injury: [BI]
Douglas B Cooper, Anne E Bunner, Jan E Kennedy, Valerie Balldin, David F Tate, Blessen C Eapen, Carlos A Jaramillo
Increased prevalence of traumatic brain injury (TBI) has been associated with service members and veterans who completed combat deployments in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Management of persistent post-concussive symptoms (PCS) has been a challenge to healthcare providers throughout the Military and Veterans Healthcare Systems, as well as civilian healthcare providers, due in part to the chronic nature of symptoms, co-occurrence of behavioral health disorders such as depression, Posttraumatic Stress Disorder (PTSD), and substance use disorders, and fear of a potential stigma associated with psychiatric diagnoses and behavioral health treatment(s)...
September 2015: Brain Imaging and Behavior
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