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Physical Therapy Plays a Critical Role in the Evolving World of Concussion Management

March 20, 2019 in Articles, News
Posted by E. Larry Grine
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Concussions are a growing concern for athletes of all ages, as the number of affected individuals rising each year. In fact, one study suggests concussion diagnosis for athletes under 22 have risen 500% in the past decade. On average, nearly 85% of all concussions resolve within 7-10 days after injury.  Every concussion patient has a specific and unique set of symptoms related to how their body reacts to the injury. The question remains -- how do you rehabilitate those that have a slower recovery?

WHAT IS A CONCUSSION?

A concussion is a mild traumatic brain injury that is caused by a blow to the head or a jolt to the body that causes the brain to ‘rattle’ back and forth. When a concussion occurs, it can alter a person’s physical and emotional state. The symptoms commonly presented with a concussion include, but are not limited to: headaches, confusion, dizziness, nausea, lack of coordination, memory loss, and excessive fatigue. These symptoms can be categorized into six unique clinical profiles which shape the specific manner in which these patients are assessed, treated, and undergo rehabilitation.

THE 6 CLINICAL PROFILES OF CONCUSSIONS: 
   
                                                                    

1.      Vestibular
         - Dizziness/balance issues

2.      Ocular
          - Eye position dysfunction and eye movement difficulties

3.      Cognitive / Fatigue
          - Difficulties in concentration, cognitive tasks, and sleep patterns

4.      Post-Traumatic Migraine
          - Persistent migraine headaches

5.      Cervical Spine (Neck)
          - Joints and muscles of the neck

6.      Anxiety / Mood
         - Anxiety and mood changes

CONCUSSION TREATMENT: HOW CAN PHYSICAL THERAPY AID IN REHABILITATION?
We now know through research advancements over the past decade that each patient who suffers a concussion will experience different symptoms that are categorized according to the six clinical profiles mentioned above. Based on which of the clinical profiles (not exclusive) the symptoms align with, patients would then undergo unique and specific treatment from an appropriate specialist.

Physical therapy plays a vital role in the treatment of two of the clinical profiles, vestibular and cervical spine/neck, and also provides graded exercise therapy which benefits all concussion sufferers.

VESTIBULAR REHABILITATION

During a concussion, the brain strikes the inner surface of the skull and rebounds against the opposite side. This can cause our inner ears to send incomplete or inaccurate signals to the brain resulting in dizziness, vertigo, and loss of balance. To combat this, vestibular rehabilitation programs help to improve the central nervous system to ‘re-balance’ the inner ear. This is accomplished through a comprehensive exercise-program designed specifically to the patient’s tolerance, physical condition, and concussion symptomatology.

CERVICAL SPINE TREATMENT (NECK)

Interestingly, the cervical spine is often overlooked and under-treated following a concussion. Research shows the G-forces required to cause a concussion range from 70-120 G-forces. However, whiplash injuries to the neck only requires a 4.5 G-force impact. Several evidence-based articles highlight that nearly 100% of concussion patients also suffer from a whiplash neck injury. This information highlights the importance of assessing and treating the cervical spine for all concussion patients.

GRADED EXERCISE THERAPY

The treatment of concussions used to be rest. The patient would rest for a significant amount of time before attempting activity. Research now shows us improvements can be accelerated with carefully graded exercise therapy early in the recovery process. Findings also show graded exercise therapy can also jump-start recovery with patients who have had difficulty recovering from concussions.

BEGIN YOUR CONCUSSION REHABILITATION AT VTFC!

Over the past several years valuable information has emerged regarding concussion and concussion management. Through excellent clinical practices and emerging evidence providers can now provide a clearer picture and pathway for treating patients suffering from concussions.

If you have experienced a concussion and are looking for a specialist to assist with vestibular rehabilitation or treatment of the cervical spine (neck) contact our team to schedule an initial evaluation. Getting specialized care for your concussion will get you on the road to recovery more quickly!

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