Rehabilitation of Persistent Symptoms After Concussion

Tapia, Rebecca N.; Eapen, Blessen C.

doi:10.1016/j.pmr.2016.12.006

Cited by 16 publications

(9 citation statements)

References 46 publications

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“…in some cases 6 . mTBI can result in a wide range of physical, cognitive, psychological and social impairments 7,8 that affect a person's ability to recover post injury and resume life roles and activities of daily living, such as return to play or work.…”

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confidence: 99%

Sex-specific differences in resting-state functional connectivity of large-scale networks in postconcussion syndrome

Shafi

Crawley

Tartaglia

et al. 2020

Sci Rep

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Concussions are associated with a range of cognitive, neuropsychological and behavioral sequelae that, at times, persist beyond typical recovery times and are referred to as postconcussion syndrome (PCS). There is growing support that concussion can disrupt network-based connectivity post-injury. To date, a significant knowledge gap remains regarding the sex-specific impact of concussion on resting state functional connectivity (rs-FC). The aims of this study were to (1) investigate the injury-based rs-FC differences across three large-scale neural networks and (2) explore the sex-specific impact of injury on network-based connectivity. MRI data was collected from a sample of 80 concussed participants who fulfilled the criteria for postconcussion syndrome and 31 control participants who did not have any history of concussion. Connectivity maps between network nodes and brain regions were used to assess connectivity using the Functional Connectivity (CONN) toolbox. Network based statistics showed that concussed participants were significantly different from healthy controls across both salience and fronto-parietal network nodes. More specifically, distinct subnetwork components were identified in the concussed sample, with hyperconnected frontal nodes and hypoconnected posterior nodes across both the salience and fronto-parietal networks, when compared to the healthy controls. Node-to-region analyses showed sex-specific differences across association cortices, however, driven by distinct networks. Sex-specific network-based alterations in rs-FC post concussion need to be examined to better understand the underlying mechanisms and associations to clinical outcomes.

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confidence: 99%

Sex-specific differences in resting-state functional connectivity of large-scale networks in postconcussion syndrome

Shafi

Crawley

Tartaglia

et al. 2020

Sci Rep

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“…1,2 Symptoms of concussion may include headache, dizziness, poor sleep, difficulties concentrating, irritability, and mood changes. 3,4 Concussions are a major public health issue with estimates that one in five adolescents have experienced a concussion in their lifetime. 5 Although symptoms typically resolve within 28 days post concussion for a majority of adolescents, as many as 30% of patients report continued symptom burden beyond this time.…”

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confidence: 99%

The association between sleep and physical activity with persisting postconcussion symptoms among adolescent athletes

Neely

Smulligan

Wingerson

et al. 2023

PM&R

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BackgroundBoth sleep duration and physical activity following concussion may influence subsequent recovery. Objective measurement of sleep and physical activity behavior via wearable technology may provide insights into their association with concussion recovery.ObjectiveTo determine whether sleep behavior (eg, duration, timing) and/or physical activity (steps/day, or exercise frequency, duration, intensity) in the first month after adolescent sports‐related concussion are associated with developing persisting postconcussion symptoms (PPCS).DesignCase–control.SettingOutpatient sports medicine clinic.ParticipantsThe study prospectively enrolled adolescent athletes who sustained a concussion (N = 49, age = 14.8 ± 1.8 years; 51% female) who were evaluated within 14 days of concussion (mean = 6.7 ± 2.7 days) and followed uvia sleep/physical activity monitoring for the subsequent 2 weeks.Main Outcome MeasuresParticipants wore a monitor to track sleep (sleep time, wake time, and time spent awake in bed at night) and physical activity (average steps/day, exercise frequency, exercise duration) behavior for 2 weeks after initial assessment. Participants were followed until symptom resolution, and the main outcome of interest was development of PPCS (symptom duration >28 days). A multivariable logistic regression model was used to examine associations between physical activity and sleep behavior with PPCS.ResultsOf the 49 participants, 47% (n = 23, mean symptom resolution = 57 ± 23 days post injury) developed PPCS and 53% (n = 26, mean symptom resolution = 15 ± 7 days post injury) did not. Univariable analysis showed that the PPCS group took fewer steps/day (7526 ± 2975 vs. 9803 ± 3786 steps/day; p = .02), exercised less frequently (2.5 ± 2.2 vs. 4.4 ± 2.1 days/week; p = .005), and spent more time in bed awake (1.2 ± 0.3 vs. 0.8 ± 0.3 h/night; p = .03) than the no PPCS group. Multivariable results indicated the odds of developing PPCS significantly increased with fewer exercise session/week (adjusted odds ratio = 1.96, 95% confidence interval = 1.09, 3.51, p = .024).ConclusionsMore exercise sessions that were longer than 15 minutes during concussion recovery was associated with a lower risk of developing PPCS, whereas sleep and other physical activity measures were not. Further studies regarding exercise duration and intensity are needed. Clinicians may consider advising patients to optimize sleep and physical activity during concussion recovery.

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“…(eg, sleep hygiene, minimizing stress, avoiding triggers), and over-the-counter analgesics. 4,8,9 Although concussion symptoms typically resolve within a few weeks, 2,10,11 some people may continue to experience persistent symptoms-greater than 10 to 14 days in adults and greater than 4 weeks in children. 2 In some circumstances, patients may seek nonpharmaceutical therapies, such as osteopathic cranial manipulative medicine (OCMM), when concussion symptoms do not respond to current conventional postconcussion treatment options.…”

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confidence: 99%

“…2 In some circumstances, patients may seek nonpharmaceutical therapies, such as osteopathic cranial manipulative medicine (OCMM), when concussion symptoms do not respond to current conventional postconcussion treatment options. 4,12 Currently, OCMM is not considered part of the conventional treatment for patients with postconcussive symptoms. 4,8,9 William G. Sutherland, DO, developed OCMM in the early 1930s to assess and alleviate cranial bony and myofascial dysfunctions 13,14 that may arise from various injuries.…”

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confidence: 99%

“…4,12 Currently, OCMM is not considered part of the conventional treatment for patients with postconcussive symptoms. 4,8,9 William G. Sutherland, DO, developed OCMM in the early 1930s to assess and alleviate cranial bony and myofascial dysfunctions 13,14 that may arise from various injuries. Assessment of cranial dysfunctions requires a working knowledge of the cranial bony anatomy and how the cranium is connected via the falx cerebri, falx cerebelli, and tentorium cerebelli to the base of the spine at S1 to S2, the terminus of the dura.…”

mentioning

confidence: 99%

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Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study

Patel¹,

Sabini²

2018

Journal of Osteopathic Medicine

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Rehabilitation of Persistent Symptoms After Concussion

Cited by 16 publications

References 46 publications

Sex-specific differences in resting-state functional connectivity of large-scale networks in postconcussion syndrome

Sex-specific differences in resting-state functional connectivity of large-scale networks in postconcussion syndrome

The association between sleep and physical activity with persisting postconcussion symptoms among adolescent athletes

Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study

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