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Concussion Assessment and Management

Concussion, also known as a traumatic brain injury (or TBI) is functional disturbance of the brain, typically caused by direct or indirect trauma. As with any injury, concussion needs to be assessed and treated in the correct manner to optimise recovery and avoid long-term disabilities.

The acute evaluation involves questioning (using a specific tool such as the sport concussion assessment tool (SCAT)), to ascertain if the person has suffered a concussion.

Acute symptoms of a concussion may include headache, brain fog, balance impairment, mood changes, delayed reaction times and sleep issues.

A person does not need to lose consciousness to have suffered a concussion.

The initial management of concussion involves RELATIVE rest from both physical AND cognitive load, to allow symptoms to settle.

Following this, graded exposure to loading (at an intensity and duration that does not worsen symptoms) is imperative to regain tolerance to normal activity.

The trauma required to cause a concussion may also cause injury to the neck, which may then compound the symptoms of the concussion.

Therefore, the neck must also be examined and addressed where needed.

Impaired vestibular and oculomotor function (these are systems that contribute to sensory awareness and balance) is common and need to be assessed. If deficits are noted, these need to be addressed with specific rehabilitation techniques.

Balance is also often impaired. A balance assessment will help identify these impairments and guide the progression of a balance program.

The trauma involved with a concussion may cause psychological stress and fear to return to activity. These psychological aspects need to be investigated and addressed appropriately.

Inappropriate assessment and management of concussion can lead to prolonged recovery and negatively impact quality of life and performance. If you or someone you know has suffered a concussion, please contact us to get started on the most appropriate rehabilitation plan.

If you would like to learn more about concussion then check out the following podcast episode:

Wingerson, Mathew J., Julie C. Wilson, Corrine N. Seehusen, Gregory Walker, and David R. Howell. “DETERMINANTS OF IMMEDIATE AND DELAYED RECALL PERFORMANCE FOLLOWING PEDIATRIC CONCUSSION.” Orthopaedic Journal of Sports Medicine 9, no. 7_suppl3 (2021): 2325967121S00148.

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