Background: Concussions, or mild traumatic brain injuries, are prevalent among youth and young adults. These injuries may disrupt a person's daily activities (occupations) including school, physical activity, work, and socialization. Rehabilitation professionals, such as occupational therapists (OTs), are experts in providing individualized intervention to address these temporary life changes during recovery. Objective: This article aims to identify the benefit of having an occupational therapy practitioner on an interdisciplinary treatment team when providing intervention to patients with concussion. Setting: Concussion clinic at an academic institution. Participants: Participants ages 12 to 24 years with a reported history of mild traumatic brain injury or concussion were evaluated by a physician, or by a physician and OT, in an initial evaluation appointment. Design: A single researcher (OT) with training in concussion qualitatively compared reported impacted occupational domains as defined in the Occupational Therapy Practice Framework, using both a retrospective and a prospective cohort. The prospective group differed from the retrospective group in that an OT was present, and participated in the initial evaluation. Results: The domains of performance patterns (P = .007) and performance skills (P ≤ .001) were identified significantly more often when an occupational therapy practitioner participated in the initial evaluation. Conclusions: Rehabilitation professionals, such as OTs, play an important role in identifying impacted domains after a concussion, which can help optimize patient care.

Ensuring that older adults are receiving quality and effective rehabilitation and skilled nursing services must be a priority to society and to the health care system, but health care policies and systems driving reimbursement continue to challenge the delivery of services. A review of the literature indicates significant problems among residents of skilled nursing facilities (SNFs) that could be alleviated by meaningful occupational therapy. Research and practice in the occupational therapy community should focus on this large area of practice. Advocacy by individual practitioners-challenging themselves and others to provide more patient-centered care-can lead to changes that benefit clients, facilities, and payment systems as well as contribute to career satisfaction of occupational therapy practitioners. Occupational therapy can and should serve as catalyst for culture change in SNFs by providing meaningful interventions and opportunities that support engagement and health.

ObjectiveTo identify whether patients referred to occupational therapy (OT) in a specialty concussion clinic differ clinically from those not referred.BackgroundLiterature pertaining to OTs role in concussion management is limited (Finn, 2019) and research primarily explores moderate to severe traumatic brain injury (TBI) (Cogan 2014).Design/MethodsUsing a cohort from an interdisciplinary concussion clinic at an academic institution, demographics, injury characteristics, patient/family history, and neurologic exam results were obtained from complete medical records of patients 8–75 years with mild TBI. Patients with moderate or severe TBI were excluded. Records were reviewed from initial neurology visits between January and April 2020 if OT was present or patient was referred to OT. Outcomes included days since initial injury, days missed/current participation in school, work, exercise, social and leisure activity, impacted sleep and routine. Referrals were decided by visit physician. R Version 3.6.3 was used to analyze data.Results42 of 48 records met inclusion criteria. 16 were referred (REF) to OT, 26 not referred (NOT). REF were 81% female, mean age 21.9 years. NOT were 46% female, mean age 26.4 years. The robust Yuen test showed REF were further post-initial injury (204.9 days vs 90.44 days; p = 0.043), missed more school or work (35.9 days vs 7.5 days, p = 0.015) and exercise (58.6 days vs 16.81 days; p = 0.022) following concussion. REF also lacked a daily routine (p = 0.029) and were not socially active (p < 0.001). Current participation in school, work, exercise, or leisure, as well as impacted sleep showed no statistically significant group differences.ConclusionsPatients referred to OT after evaluation in an interdisciplinary concussion clinic experienced prolonged recovery with protracted durations of inactivity, lack of daily routine and absence of social activity. Future research should explore whether factors like symptom burden, pain, or comorbidities may account for these differences and provide clinicians with earlier indication for OT referral.

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This descriptive study examined OT referrals in an interdisciplinary concussion clinic. Data analyzed show that patients referred to OT presented to clinic evaluation further out from injury; had missed more days from school, work, and physical activity; were lacking a routine; and were not socially active. These results provide variables that indicate the need for OT assessment, guide clinicians in the referral process, and advance the role of OT in concussion management. Primary Author and Speaker: Shannon S. Westerberg Additional Authors and Speakers: Madison Harris Contributing Authors: Samia Rafeedie, David McArthur, and Christopher Giza