An Occupation-Based Approach to Management of Concussion: Guidelines for Practice

Abstract

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.

Occupational and Physiotherapy modalities used to support interdisciplinary rehabilitation after concussion: A Scoping Review

“…The therapeutic rehabilitation modalities identified were mainly delivered by an interdisciplinary team or solely by PTs. OTs only participated in the rehabilitation process in two studies despite evidence for OTs’ contribution in managing symptoms and facilitating gradual return to activities and work has shown to positively impact quality of life ( 46 , 59 ). There may be several reasons for OTs being under-represented in the included studies; however, a possible explanation may be that OTs more often get involved if the patient needs return-to-work support ( 60 ).…”

Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol

“…15,16 In some cases, enduring PPCS may result in disability, 16 affecting the person's independence and/or ability to participate in everyday activities. 17 Thus, in persisting cases, the "mild" brain injury they sustained is a misnomer due to the ongoing significant challenges experienced in everyday life. 18 Recovery following concussion injuries can be complex due to variable factors, such as an individual's symptom profile; identified goals; and knowledge of and access to concussion-specific rehabilitation programs with expert practitioners.…”

“…These concepts are, therefore, useful to consider within holistic occupational therapy assessment and intervention processes and can also aid understanding about the role of occupational therapists in health services and systems. 23 Despite growing recognition of the role occupational therapy can offer in mTBI rehabilitation, 17,18,20,24 there has been limited examination of the profession's contribution to the rehabilitation of adults experiencing PPCS. [17][18][19]25 This scoping review will build on recent works that have explored interventions provided by occupational therapists for adults with PPCS.…”

“…23 Despite growing recognition of the role occupational therapy can offer in mTBI rehabilitation, 17,18,20,24 there has been limited examination of the profession's contribution to the rehabilitation of adults experiencing PPCS. [17][18][19]25 This scoping review will build on recent works that have explored interventions provided by occupational therapists for adults with PPCS. 18,19,25 A search of MEDLINE, PROSPERO, and JBI Evidence Synthesis was conducted in April 2023 to screen for previous works.…”

“…PPCS experienced by adults beyond 2 to 4 weeks post-TBI may include a “cluster” of symptoms that often fall into 3 clinically relevant domains (somatic, cognitive, and emotional 9 ) and may include fatigue, vestibular dysfunction, and vision and cognitive problems 15,16 . In some cases, enduring PPCS may result in disability, 16 affecting the person’s independence and/or ability to participate in everyday activities 17 . Thus, in persisting cases, the “mild” brain injury they sustained is a misnomer due to the ongoing significant challenges experienced in everyday life 18 …”