Neuropsychological and psychological rehabilitation interventions in refractory sport-related post-concussive syndrome

Abstract

Modified approaches for rehabilitation with young children within family and school systems are provided. Recommendations for further research are offered.

An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations

“…4,12,13,[17][18][19][20][21][22][23][24][25][26] The EEG, which records electrical activity of the brain over time, was introduced in 1929 and was shown to respond to volitional control via operant conditioning by 1962. 12,18,27 More recently, with the corresponding technological advances computers provided, quantitative EEG, which digitizes the EEG signal, has been introduced as the newer generation of EEG neurofeedback.…”

“…4,12,18,[27][28][29] EEG patterns have been shown to be different in individuals following TBI, and have even been shown to predict prognosis in some cases. 7,12,26,27 Sideeffects from neurofeedback can include headaches, nausea, dizziness, fatigue, and agitation. 18 These are common symptoms that TBI survivors seek to mitigate that might be worsened by the use of a computer screen to provide feedback, which can exacerbate symptoms in some patients with brain injuries.…”

“…At least 1 researcher has suggested that, for this reason, other forms of biofeedback or relaxation training, or the use of audio feedback versus computerbased visual feedback, may be suited better to patients who are early in their TBI recovery and/or more sensitive to the effects of a computer screen on their symptoms. 26 As with other forms of biofeedback, the principles of helping train users to become more of aware of the patterns that might be contributing to symptoms and/or interfering with performance or health, and learning to change these patterns by receiving audio, visual, and/or sensory feedback in real time, is the same. The number of sessions required in order to achieve positive change may range from 5 to 60, sometimes involving more than 1 session per week to help generalize skills and improve outcomes.…”

“…18 Although the research still lacks a large body of randomized, double-blinded, placebo-controlled studies following standardized protocols, the literature does suggest that survivors-in both civilian and military populationsof brain injuries of differing levels of severity report improvements across a wide range of complaints of problems with attention, impulse control, processing speed, shortterm memory, and mood. 4,8,[12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29] Research on the use of neurofeedback for veteran populations has often focused on its use when PTSD or substance abuse is comorbid with TBI from blast injuries, with significant improvements reported, once the original protocol was modified. 18,28 Generalizability from the research is complicated by not only the lack of randomized, double-blinded, placebo-controlled studies following standardized protocols, but also by the variety of types and causes of TBIs.…”

Collaborative Care for Adolescents With Persistent Postconcussive Symptoms: A Randomized Trial

“…18 Cognitive-behavioral therapy (CBT) has been recommended as a first-line treatment of persistent postconcussive symptoms based on studies with adults after concussion. 13,19 Robust evidence has documented that CBT is effective in the treatment of adolescent depression, anxiety, and chronic pain. 20,21 Psychopharmacological management of co-occurring mood disorders requires close coordination and collaboration between physicians with specialized clinical training and experience in traumatic brain injury and child psychiatry.…”