A concussion is an individualized injury that presents with a myriad of cognitive, physical, emotional, somatic, and sleep-related symptoms and impairments that should require a multifaceted approach to assessment and management. Despite a significant increase in research dedicated to identifying and managing sport-related concussion, it remains one of the most complex injuries sports medicine professionals face.
Historically, concussion has been managed with a more conservative approach of cognitive and physical rest. Post-concussion, individuals are frequently advised to avoid activity until he or she is symptom free. As research and practice evolve, a significant gap exists between the historically conservative approach versus a more active treatment approach in both perceived public perception and clinical practice[3,4].
Moving beyond “rest and monitor” and establishing clinical profiles and targeted recovery approaches has become the focus of modern concussion treatment but has received limited attention in the literature and the need to focus on process not protocol is paramount in continuing to advance effective treatment of sport-related concussion. Further studies are needed to evaluate long-term outcomes of early intervention and test the safety and efficacy of active rehabilitation in the acute post-injury period to optimize a shorter duration of symptoms and improved return to play outcomes.
Of equal importance is implementing cervical strengthening training sessions in both pre-season and post-injury that have been found to decrease the risk of concussion and improve recovery time[6,7]. Additionally, the high prevalence of concussion-related vision disorders supports the need for appropriate clinical testing of oculomotor control.
Research suggests vision therapy can be an effect intervention[8,9]. It is vitally important the healthcare professional have a solid understanding of a multi-faceted approach from baseline to sideline to post-injury and throughout the recovery process to minimize the risk associated with concussions as well as decrease the duration of symptoms and optimize best outcomes for a safe return to activity.
Join us at The Concussion Health Summit where we will be discussing and providing strategies for these educational needs and practice gaps. The early bird discount expires on June 30th and hotel rooms are filling up fast. Click here to register. We look forward to seeing you at the Summit!
Bridgett Wallace, PT, DPT
Director of Clinical Education, Concussion Health
President, 360 Balance & Hearing
Concussion Health Summit Co-Chair
Mark Letendre, ATC
Director of Umpire Medical Services
Office of the Commissioner
Major League Baseball (MLB)
Concussion Health Summit Co-Chair
1. Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: evaluation and management of concussion in sports. Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013; 80(24):2250–2257.
2. University of Pittsburgh Medical Center Sports Medicine Concussion Program (2015). How knowledgeable are Americans about concussions? Assessing and recalibrating the public’s knowledge. Retrieved from http://rethinkconcussions.upmc.com/wp-content/uploads/2015/09/harris-poll-report.pdf.
3. Thomas DG, Apps JN and et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatr. 2015;135(2);213-223.
4. Strelzik J and Langdon R. The role of active recovery and rest after concussion. Pediatr Ann. 2017;46(4):139-144.
5. Institute of Medicine of the National Academies (2013). Sports-related concussions in youth improving the science, changing the culture. Sports-Related Concussions in Youth Improving the Science, Changing the Culture.
6. Gilchrist I, Storr M and et al. Neck muscle strengthening in the risk management of concussion in contact sports: critical appraisal of application… J Athl Enhancement, 2015;4:2-19.
7. Collins CL, Fletcher EN and et al. Neck strength: a protective factor reducing risk for concussion in high school sports. J Prim Prev, 2014;35(5):309-19.
8. Gallway M, Scheiman M and Mitchell GL. Vision Therapy for Post-Concussion Vision Disorders. Optom Vis Sci, 2017;94(1):68-73.
9. Kontos, AP, Deitrick JM and et al. Review of Vestibular and Oculomotor Screening and Concussion Rehabilitation. J Athl Train, 2017;52(3):256-261.
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