Current Concepts in Concussion Rehabilitation

Abstract

Active rehabilitation of sport injuries is a concept familiar to athletes and those caring for them. Rehabilitation goals aim to optimize recovery efficiency and diminish chances of repeat injury. Rehabilitation programs take many aspects of recovery and wellness into consideration including physical, social, and psychologic components. Ultimately, this is important in the recovery process after concussion. In this article we introduce the largely unexplored concept of multidimensional concussion rehabilitation and discuss physical, psychologic, social, and sport-specific issues. As well, we propose future directions in this field.

Aggressive Rehabilitation Pathway Targeting Concussion Symptoms: Illustration with a Case Study

“…It is often recommended to wait for resolution of symptoms before initiating a structured rehabilitation program [3,4,23], but based on our patient's circumstances the symptoms needed to be addressed more directly [24]. Our program regularly engages symptoms in rehabilitation designed to work around and address them so improvement can be achieved.…”

“…This relative lack of understanding of concussion, concussion diagnosis, concussion management and evidence based medicine concerning rehabilitation post mTBI has led to confusion regarding the types of treatment needed in these patients [2]. It is generally recommended that a subject rest until symptoms resolve [3][4][5][6]. The presence of frontal lobe damage and the dysfunctions that accompany it can impact a rehabilitation program [7].…”

A Review of Return to Play Issues and Sports-Related Concussion

“…Johnston et al have suggested a clinical strategy for concussion rehabilitation and RTP that is summarized below. 10,15 1. Prevent or correct additional disability-The authors enforce, through discussion about resistance training, the importance of following the step-wise RTP protocol as previously discussed.…”

“…Cervical soft tissue injuries can be associated with headaches and should be differentiated from migraines and post-concussive headaches. 15 Athletes with learning disabilities may have baseline cognitive deficits, and therefore should not be overlooked. More precautions should be used in these athletes and the progression through the RTP protocol should be increased.…”

“…There is a correlation with concussion and depression which may persist longer than physical symptoms. 15 Horton found that athletes who participated in support group after concussive injury had less mood adjust-ment problems. 14 As previously mentioned, appropriate pharmacotherapy of mood disorder associated with concussion is an important component of management.…”