It has been estimated that it there is an average lag of 17 years from research and development (R&D) into clinical practice (Bales and Boren, 2000). Keep in mind that R&D frequently does not include those providers in the field that are practicing cutting edge medicine based on anecdotal findings…anecdotal findings that produce positive outcomes and most often in fewer visits. Concussion Health’s Scientific Advisory Team is comprised of a number of experts in the area of concussion management who have been practicing cutting edge diagnostic and rehabilitation services for a number of years.
Bridgett Wallace, PT, DPT, Co-Founder and Director of Clinical Education for Concussion Health, reminds us that it was not until the Vienna Concussion Consensus Statement in 2001 that it was recommended to abandon grading of concussions primarily based on loss of consciousness. Studies now indicate that LOC occurs less than 10% of the time (Meehan, 2010). It was also noted at this time that cognitive testing was the cornerstone of a concussion management program. Most providers now know that grading a concussion is no longer considered best practice although many still consider that providing cognitive testing is enough for a concussion management program. For those leaders in the field, it is widely known that no tool should be used in isolation and that “once you have seen one concussion, you have seen one concussion” – each injury in unique to the individual.
For this reason, CH not only provides continuing education that provides information on best practice but also develops best practices. The evolution of Concussion Health began upon the encouragement of Tina Bonci, MS, ATC, LAT in 1997 – a pioneer in athletic training protocols. Tina partnered with an ENT and Bridgett to evaluate and treat an athlete who had suffered a concussion and was having residual symptoms, although her cognitive testing was within her baseline score. It was discovered that her impairments were in visual and vestibular dysfunction. She followed a recommended vestibular therapy program that improved her symptoms significantly.
Based on such findings, baseline testing was extended to computerized vestibular testing for both balance and eye-head coordination, and follow-up testing was performed in a comprehensive balance center. Within a couple of years, it was also discovered that many individuals, following head trauma, not only had findings in their vestibular testing but also in their oculomotor control. Patterns within such testing were also discovered in certain types of injuries – particularly whiplash injuries.
With the ever-growing expansion of mixed learning through live courses and online courses, Concussion Health was founded in 2009 to provide online education specific to concussion management in an effort to share these findings and bridge the gap between sports medicine and vestibular therapy, as well as emphasize the importance of vision assessment and therapy. Concussion Health has excitingly watched the growth of more recent interest in these areas.
What we are even more excited to see is the discussion trend toward not just diagnosing a concussion but treating it as a manageable injury.
In the last year, there has been an enormous amount of research by UPMC in this area and by Banner Concussion Center in Phoenix, AZ – specific to the vestibular-visual components related to residual symptoms post head trauma. The educational tools provided by Concussion Health emphasize the importance of an inter-disciplinary approach to concussion management and recognize that any successful treatment program begins with an accurate examination and evaluation.
There is research dating back to 600 AD that differentiates clinical presentations from traumatic brain injury to a concussion (McCrory and Johnston, 2002) and surprisingly enough that an oculomotor assessment has been a critical component post head trauma for more than 3,500 years. More recently, there have been a handful of studies showing the benefits of visual and vestibular therapy associated with head trauma (Alsalaheen et al, 2010; Weightman et al, 2010).
Although we are getting closer to more affordable means to diagnose a concussion, the diagnosis does not define the treatment/recovery process. Concussion Health is proud to be a part of this evolving field that not only follows best practice but we develop it.
Concussion Health Updates
Here's what we've added to Concussion health lately...