Active rehabilitation for concussion management has 3 parts:
1. Identify the patient's primary concussion profile with objective deficits
2. Treat the deficits with targeted exercises for that profile
3. Step wise progression back to exercise based on symptoms.
Through research we have been able to identify 6 profiles for sport related concussions. All patients fall into 1 primary profile but most of the time there is overlap with 2-3 profiles. The 6 profiles are cervical (neck), cognitive/fatigue, visual, vestibular, migraine and anxiety/mood. Without identifying the profile the treatment can not be appropriately targeted or effective. Providing balance exercises for someone dealing with a visual profile will not address the problem and will not be the solution for that patient.
The profile is developed by listening to a patient’s story, getting an in-depth history, understanding immediate symptoms after the concussion and the current issues they are experiencing. Apart from understanding the symptoms, a hands-on examination is also needed. In our practice, we always assess the balance system, the coordination of the eyes, and perform an orthopedic examination of the cervical spine in terms of motion, pain and control.
Once the profile is identified, active rehabilitation can begin. We know through years of research that simply resting and avoiding activity does more harm than good. We no longer treat concussions passively with rest, avoiding light and stimulus and waiting for the brain to heal. Now we treat concussions actively!
1. Identify the patient's primary concussion profile with objective deficits
2. Treat the deficits with targeted exercises for that profile
3. Step wise progression back to exercise based on symptoms.
Through research we have been able to identify 6 profiles for sport related concussions. All patients fall into 1 primary profile but most of the time there is overlap with 2-3 profiles. The 6 profiles are cervical (neck), cognitive/fatigue, visual, vestibular, migraine and anxiety/mood. Without identifying the profile the treatment can not be appropriately targeted or effective. Providing balance exercises for someone dealing with a visual profile will not address the problem and will not be the solution for that patient.
The profile is developed by listening to a patient’s story, getting an in-depth history, understanding immediate symptoms after the concussion and the current issues they are experiencing. Apart from understanding the symptoms, a hands-on examination is also needed. In our practice, we always assess the balance system, the coordination of the eyes, and perform an orthopedic examination of the cervical spine in terms of motion, pain and control.
Once the profile is identified, active rehabilitation can begin. We know through years of research that simply resting and avoiding activity does more harm than good. We no longer treat concussions passively with rest, avoiding light and stimulus and waiting for the brain to heal. Now we treat concussions actively!
