No abstract

Concussions have been increasingly reported over the past decade, but the reported incidence likely minimizes the actual numbers of people affected. Associated symptoms include emotional, somatic, and cognitive complaints, which may be prolonged in patients with certain risk factors. Neurologic examination is necessary to exclude upper motor neuron lesions and thus the need for brain imaging. Cervical conditions are often found concurrently with head injury and displays a similar presentation to concussions. Therefore, determining symptom origin can be problematic. Neuropsychological, oculomotor, and balance evaluations expose specific deficits that can be successfully managed with rehabilitation. Osteopathic assessment of the cranium, spine, sacrum, and thorax for somatic dysfunctions allows for prudent interventions. Patients involved in sports may begin an established graduated return-to-play protocol once cleared by their physician. Concurrently, a parallel return-to-learn program, with applicable academic accommodations, is recommended.

Concussion and the cumulative effects of repetitive head trauma have become a growing health concern both in the mainstream media and in the health care community. Although symptoms of concussion are not always outwardly visible, evidence suggests that post-concussion symptoms may interfere with an individual's ability to work, play, and participate in school. In the past, the recommendations following concussion emphasized a complete rest approach, whereas current approaches focus on a gradual engagement in functional activities shortly after the injury. Since current recommendations are focused on a gradual engagement in occupation and activity, occupational therapy may be a valuable service for individuals who have sustained concussions. However, despite the valuable role that occupational therapy may offer, there is limited literature supporting the role of occupational therapy in the management of concussion, and there are currently no clear guidelines for clinical practice. This paper will provide an overview of an occupation-based, client-centered framework for the management of concussion and specific guidelines for occupation-based assessments and interventions. Comments The author reports that they have nothing to disclose.

All authors contributed to the study conception and design. SB carried out the experiments, performed the acquisition, analysis, and interpreted the data. AM, DC, VD, and CF participated in experiments. NP involved in mouse behavioral studies. AMPM and SB wrote the manuscript. AMPM designed the project, supervised the execution of the experiments, and interpreted and analyzed the data. All authors read and approved the final manuscript.