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Concussion clinic

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By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/28211600/feasibility-of-early-physical-therapy-for-dizziness-after-a-sports-related-concussion-a-randomized-clinical-trial
#1
J C Reneker, A Hassen, R S Phillips, M C Moughiman, M Donaldson, J Moughiman
The purpose of this study was to (a) assess the feasibility of recruitment/retention of participants, protocol/resource management, and participant safety, and (b) estimate the size of the effect between the experimental and control groups. This was a feasibility study conducted as a prospective pilot double-blind randomized clinical trial. Subjects aged 10-23 years old with acute concussion and dizziness were enrolled from sports medicine centers. Forty-one participants were randomized into treatment and were seen for physical therapy beginning at 10 days post-concussion...
February 17, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28202206/retrospective-chart-analysis-of-concussion-discharge-instructions-in-the-emergency-department
#2
Allison D Lane, Matthew R Berkman, David Verbunker, Taylor Shekell, Michael Bouska, Lauren Barnett, Allie Keogh, Tomas Nuno, Uwe Stolz, Anna L Waterbrook
BACKGROUND: Recognition and diagnosis of concussion is increasing, but current research shows these patients are discharged from the emergency department (ED) with a wide variability of recommendations and instructions. OBJECTIVE: To assess the adequacy of documentation of discharge instructions given to patients discharged from the ED with concussions. METHODS: This was a quality-improvement study conducted at a University-based Level I trauma center...
February 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28198194/assessing-the-clinical-utility-of-the-question-is-your-child-are-you-back-to-normal-in-pediatric-concussion-symptom-resolution
#3
Brandi L Vollmer, Michael W Kirkwood, R Dawn Comstock, Dustin Currie, Joseph A Grubenhoff
This study investigates the relationship between the general question, "Is your child/are you back to normal?" and a validated postconcussive symptom scale when assessing symptom resolution following concussion. Children with acute concussion were enrolled during an emergency department visit. Sensitivity and specificity analyses compared the true/false question, "My child is/I am back to normal" at 3 days postinjury with the Concussion Symptom Inventory (CSI; gold standard). A total of 201 participants were enrolled in the study with complete data...
February 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28195951/assessment-of-oculomotor-function-in-patients-with-postconcussion-syndrome-a-systematic-review
#4
Foad Taghdiri, Brenda Varriano, Maria Carmela Tartaglia
BACKGROUND: Concussion and its associated sequel, postconcussion syndrome (PCS), have a debilitating impact on the lives of concussed patients. However, a diagnostic biomarker for this condition is lacking. Recently, there has been a surge of interest in using oculomotor function testing as an objective assessment of patients with PCS. OBJECTIVES: To systematically synthesize, appraise, and summarize all published empirical studies that have assessed alteration of oculomotor functions in patients with PCS...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28192036/using-acute-performance-on-a-comprehensive-neurocognitive-vestibular-and-ocular-motor-assessment-battery-to-predict-recovery-duration-after-sport-related-concussions
#5
Alicia M Sufrinko, Gregory F Marchetti, Paul E Cohen, R J Elbin, Valentina Re, Anthony P Kontos
BACKGROUND: A sport-related concussion (SRC) is a heterogeneous injury that requires a multifaceted and comprehensive approach for diagnosis and management, including symptom reports, vestibular/ocular motor assessments, and neurocognitive testing. PURPOSE: To determine which acute (eg, within 7 days) vestibular, ocular motor, neurocognitive, and symptom impairments predict the duration of recovery after an SRC. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 2...
February 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28169147/single-task-and-dual-task-tandem-gait-test-performance-after-concussion
#6
David R Howell, Louis R Osternig, Li-Shan Chou
OBJECTIVES: To compare single-task and dual-task tandem gait test performance between athletes after concussion with controls on observer-timed, spatio-temporal, and center-of-mass (COM) balance control measurements. DESIGN: Ten participants (19.0±5.5years) were prospectively identified and completed a tandem gait test protocol within 72h of concussion and again 1 week, 2 weeks, 1 month, and 2 months post-injury. Seven uninjured controls (20.0±4.5years) completed the same protocol in similar time increments...
January 24, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/28170122/utility-of-serum-biomarkers-in-the-diagnosis-and-stratification-of-mild-traumatic-brain-injury
#7
Lawrence M Lewis, Derek Schloemann, Linda Papa, Robert Fucetola, Jeffrey Bazarian, Miranda Lindburg, Robert Welch
OBJECTIVE: To compare test characteristics of a single serum concentration of glial fibrillary acidic protein (GFAP), S-100β, and ubiquitin carboxyl terminal hydrolase L1 (UCH-L1), obtained within 6 hours of head injury, to diagnose mild traumatic brain injury (mTBI) in head-injured subjects. METHODS: Adults aged 18-80 who presented to one of seven EDs with a blunt closed head injury, underwent head CT within 4 hours of injury, and had blood drawn for biomarker analysis within 6 hours of injury were eligible...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28182530/is-state-anxiety-trait-anxiety-or-anxiety-sensitivity-a-clinical-predictor-of-symptoms-in-those-presenting-with-mild-traumatic-brain-injury-or-concussion
#8
Krista M Hixson, Alex N Allen, Andrew S Williams, Tamara C Valovich McLeod
No abstract text is available yet for this article.
February 9, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28148495/sport-related-concussion-induces-transient-cardiovascular-autonomic-dysfunction
#9
John L Dobson, Mary Beth Yarbrough, Jose Perez, Kelsey Evans, Thomas Buckley
Recent evidence suggests that concussions may disrupt autonomic cardiovascular control. This study investigated the initial effects of concussion on cardiovascular function using three autonomic reflex tests. Twenty three recreational athletes (12 females, 11 males) were divided into concussed (n = 12) and control (n = 11) groups. Concussed participants performed forced breathing, standing and Valsalva autonomic tests four times: 1) within 48 hours of injury, 2) 24 hours later, 3) 1 week after injury and 4) 2 weeks after injury...
February 1, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28124982/overview-of-traumatic-brain-injury-an-immunological-context
#10
REVIEW
Damir Nizamutdinov, Lee A Shapiro
Traumatic brain injury (TBI) afflicts people of all ages and genders, and the severity of injury ranges from concussion/mild TBI to severe TBI. Across all spectrums, TBI has wide-ranging, and variable symptomology and outcomes. Treatment options are lacking for the early neuropathology associated with TBIs and for the chronic neuropathological and neurobehavioral deficits. Inflammation and neuroinflammation appear to be major mediators of TBI outcomes. These systems are being intensively studies using animal models and human translational studies, in the hopes of understanding the mechanisms of TBI, and developing therapeutic strategies to improve the outcomes of the millions of people impacted by TBIs each year...
January 23, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28110244/quantification-of-postural-control-deficits-in-patients-with-recent-concussion-an-inertial-sensor-based-approach
#11
Cailbhe Doherty, Liang Zhao, John Ryan, Yusuke Komaba, Akihiro Inomata, Brian Caulfield
BACKGROUND: The aim of this study was to quantify postural control ability in a group with concussion compared with a healthy control group. METHOD: Fifteen concussion patients (4 females, 11 males) and a group of fifteen age- and sex-matched controls were recruited. Participants were tested during the performance of the three stance variants (bilateral, tandem and unilateral) of the balance error scoring system standing on a force place, while wearing an inertial measurement unit placed at the posterior aspect of the sacrum...
January 16, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28107556/do-post-concussion-like-symptom-responses-change-following-exercise-or-sports-participation-in-a-non-concussed-cohort
#12
Arun Prasad Balasundaram, Josie Athens, Anthony G Schneiders, Paul McCrory, S John Sullivan
The purpose of this study were; 1) To determine the reliable change in post concussion-like symptoms reported following self-selected exercise or sports activities. 2) To explore the potential influence of gender and exercise parameters on post concussion-like symptoms reported by a non-concussed cohort following exercise/training. A pre-post observational design was used. A convenience sample of students aged 18-30 years who visited a university recreation centre to engage in their chosen exercise activity, and a purposeful sample of men's and women's rugby union players engaged in their regular training sessions...
January 20, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28107216/analysis-of-central-and-peripheral-vision-reaction-times-in-patients-with-postconcussion-visual-dysfunction
#13
Joseph F Clark, James K Ellis, Timothy M Burns, John M Childress, Jon G Divine
OBJECTIVE: To determine whether central and peripheral vision reaction times (PVRTs) are prolonged in patients with visual dysfunction after sustaining a concussion. DESIGN: Comparison of Dynavision D2 central and PVRTs in patients with postconcussion visual dysfunction were compared with control data from a normative patient database. Concussion patients without visual dysfunction were not included in this study. SETTING: National Collegiate Athletic Association Division 1 college training room and university based, academic health center...
January 19, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28102739/perceptions-of-mild-traumatic-brain-injury-in-adults-a-scoping-review
#14
Katie Mah, Andrea Hickling, Nick Reed
PURPOSE: The purpose of this article is to synthesise the scholarly literature related to perceptions of mild traumatic brain injury (mTBI) and health outcomes in an adult population. METHODS: A scoping review was undertaken. An electronic search of seven databases was conducted. Studies were included if (1) they related to perceptions of mild traumatic brain injury, (2) the population was adults with mild traumatic brain injury, and (3) health outcomes were reported...
January 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28094682/development-implementation-and-assessment-of-a-concussion-education-programme-for-high-school-student-athletes
#15
Jeffrey G Caron, Scott Rathwell, J Scott Delaney, Karen M Johnston, Alain Ptito, Gordon A Bloom
Although experts have noted that adolescent athletes should be educated about concussions to improve their safety, there is no agreement on the most effective strategy to disseminate concussion education. The purpose of this study was to develop, implement and assess a concussion education programme. More precisely, four interactive oral presentations were delivered to high school student-athletes (N = 35, Mage = 15.94, SD = 0.34) in a large urban centre. Participants completed a questionnaire at three time-points during the season to measure changes in their knowledge (CK) and attitudes (CA) of concussions, and focus group interviews were conducted following the concussion education programme...
January 17, 2017: Journal of Sports Sciences
https://www.readbyqxmd.com/read/28095029/utilization-of-conventional-neuroimaging-following-youth-concussion
#16
Sean C Rose, Caroline E Schaffer, Julie A Young, Kelly A McNally, Anastasia N Fischer, Geoffrey L Heyer
BACKGROUND/OBJECTIVE: Conventional neuroimaging is not recommended for the routine diagnosis of concussion, but some patients with concussion undergo computed tomography (CT) or magnetic resonance imaging (MRI). The objective of this study was to explore the clinical factors that predict neuroimaging utilization in concussion. METHODS: Concussion-related CT and MRI data were analysed from 1953 patients, aged 10-19 years, who presented to a sports concussion clinic within 30 days of injury...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28086771/naturalistic-study-of-guideline-implementation-tool-use-via-evaluation-of-website-access-and-physician-survey
#17
Melissa J Armstrong, Gary S Gronseth, Richard Dubinsky, Sonja Potrebic, Rebecca Penfold Murray, Thomas S D Getchius, Carol Rheaume, Anna R Gagliardi
BACKGROUND: Clinical guidelines support decision-making at the point-of-care but the onus is often on individual users such as physicians to implement them. Research shows that the inclusion of implementation tools in or with guidelines (GItools) is associated with guideline use. However, there is little research on which GItools best support implementation by individual physicians. The purpose of this study was to investigate naturalistic access and use of GItools produced by the American Academy of Neurology (AAN) to inform future tool development...
January 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28085687/length-of-recovery-from-sports-related-concussions-in-pediatric-patients-treated-at-concussion-clinics
#18
Donald J Thomas, Kathryn Coxe, Hongmei Li, Thomas L Pommering, Julie A Young, Gary A Smith, Jingzhen Yang
OBJECTIVES: We quantified the length of recovery time by week in a cohort of pediatric sports-related concussion patients treated at concussion clinics, and examined patient and injury characteristics associated with prolonged recovery. DESIGN: A retrospective, cohort design. SETTING: Seven concussion clinics at a Midwest children's hospital. PATIENTS: Patients aged 10 to 17 years with a diagnosed sports-related concussion presenting to the clinic within 30 days of injury...
January 12, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28077006/longitudinal-assessment-of-health-related-quality-of-life-following-adolescent-sports-related-concussion
#19
Kelly Russell, Erin Selci, Stephanie Chu, Samuel Fineblit, Lesley Ritchie, Michael Ellis
OBJECTIVE: To examine initial and longitudinal health-related quality of life (HRQOL) in adolescent sports-related concussion (SRC) patients. STUDY: A prospective observational case-series study was conducted among adolescent SRC patients who were evaluated at a multi-disciplinary pediatric concussion program. Health-related quality of life was measured using the child self-report Pediatric Quality of Life Inventory (PedsQL) generic score scale (age 13-18 version) and the PedsQL Cognitive Functioning scale...
January 11, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28069082/legislation-for-youth-sport-concussion-in-canada-review-conceptual-framework-and-recommendations
#20
Kelly Russell, Michael J Ellis, Shannon Bauman, Charles H Tator
In this article, we conduct a review of introduced and enacted youth concussion legislation in Canada and present a conceptual framework and recommendations for future youth sport concussion laws. We conducted online searches of federal, provincial, and territorial legislatures to identify youth concussion bills that were introduced or successfully enacted into law. Internet searches were carried out from July 26 and 27, 2016. Online searches identified six youth concussion bills that were introduced in provincial legislatures, including two in Ontario and Nova Scotia and one each in British Columbia and Quebec...
January 10, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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