Concussions are complex injuries that can result in a variety of symptoms and problems, including issues with the cervical spine and vestibular system. Although most people recover in 10-14 days, evidence-based treatment may be necessary for those with ongoing or persistent symptoms.1
The good news is there is significant research and data to support psychological, cervical and vestibular rehabilitation as well as guided active rehabilitation involving controlled sub-symptom-threshold exercise.1
Scientific evidence supports early intervention of concussion via targeted treatment and rehabilitation, but what should you look for in an effective concussion care clinic?
1. Multimodal assessments
Concussion injuries can impact different areas of brain, resulting in a range of symptoms. Quality concussion care clinics should offer comprehensive pre- and post-injury assessments.
For example, a more reliable baseline test should use a series of physical and cognitive tests versus a single test alone. This may include medical history, symptom score, concentration, auditory memory, visual tracking, processing speed, reaction time, balance and centre of pressure postural sway, motor strength, and neurocognitive testing.
Another characteristic of an experienced concussion clinic is return to play testing. Sources show that many athletes are returned to sport too soon. An intense physical exertion test and symptom score can help to inform whether or not an athlete should be cleared to return to full game play.
2. Evidence-based treatment
Concussion injuries can cause a range of symptoms, including headaches, neck pain, dizziness, nausea, blurred vision, balance issues, more emotional, difficulty concentrating, confusion, irritability, and many more.
With all these possible symptoms and side effects, it makes sense that a clinic should have the necessary space and equipment to provide treatment and rehabilitation tailored to each patient. This may include:
- Exercise therapy to improve blood flow and speed recovery
- Manual therapy to reduce symptoms coming from the neck such as headaches, balance and visual issues
- Visual rehabilitation to help reduce visual abnormalities, memory problems or concentration issues
- Diet and nutritional interventions to help offset inflammation caused by the injury
- Education and reassurance to informs patients what to expect from their injury and during the recovery process
More information available on this concussion treatment and rehabilitation resource.
3. Access to multidisciplinary healthcare practitioners with specific training in concussion
Access to various healthcare practitioners from different areas of expertise (either on-site or by referral) ultimately benefits the health and well-being of the patient. Treatment should target specific medical, physical and psychosocial factors identified on assessment.1
Professional healthcare teams may include: physicians, athletic therapists, physiotherapists, chiropractors, neuropsychologists, naturopathic doctors, occupational therapists, and vision care specialists (e.g., optometrists).
Because these are difficult cases to manage, clinics should provide a tailored, multidisciplinary approach managed by healthcare providers with experience in concussion.1
4. Up to date concussion management program
The concussion management landscape is quickly changing. If you are advised to rest or hear the word Zurich, it may be a sign that you need to find another clinic.
Concussion care and management protocols should follow the most recent international consensus statement on concussion in sport (also known as the Berlin consensus).
Keep in mind that this document is updated every 4 years, and a lot can change from statement to statement, particularly in concussion care. If possible, your clinic should be as up to date as possible on the latest in concussion research. New studies are regularly published and should be considered in a clinic setting.
5. Accessible, convenient care
Access to timely care can help to facilitate appropriate recovery. Once all red flags are ruled out, research supports activation of treatment and rehabilitation within the first 2 weeks.
The sooner a patient can get in to see a licensed healthcare practitioner with training in concussion management, the sooner they can get on the right path to recovery. In the case of Complete Concussion Management, most patients can be seen by a recognized clinic within 24-48 hours!
1 McCrory et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017;0:1–10.