Concussion Management Services
ADVANCE CONCUSSION services includes education, prevention, baseline testing, consultation and rehabilitation. The clinic serves adolescents and adults, ages 15 and older, that have suffered a concussion or head injury from sports, motor vehicle accidents, falls or other head trauma. In addition to intervention, ADVANCE CONCUSSION provides recommendations on return to play, school, and work guidelines as well as academic accommodations.
Baseline Testing, Evaluation & Treatment
Baseline testing is done according to Best Practice guidelines and includes ImPACT testing, as well as baseline visual and balance tests. Post-injury, an initial evaluation is performed by our interdisciplinary team to determine the presence or degree of injury. The ADVANCE CONCUSSION team is made up of experts in the areas of:
- Neuropsychology (Brain-Behavior Functioning)
- Neuro-physiotherapy (Vestibular, Ocular-Motor, Cervical, and Musculo-Skeletal Function)
- Case Management/Patient Navigation (Comprehensive, Streamlined, Continuity of Care)
Following the initial intake evaluation, an individualized treatment plan is developed, including referral to appropriate rehabilitation services. These may include any or all of the following therapies:
Given the known relationship between thinking or cognitive abilities and the brain, cognitive changes after a concussion is a well known and easily recognized symptom group associated with brain injury. Changes in thinking can include slowed processing of information, attention and concentration difficulties, problems learning and remembering new information, trouble planning and organizing materials, difficulties with visual-spatial information, slower reaction times, and feeling cognitively “foggy.” ADVANCE CONCUSSION neuropsychology experts perform cognitive or neuropsychology assessments and use the results of computerized cognitive testing to monitor resolution of cognitive symptoms over time. Other neuropsychological testing in pencil/paper form can help ADVANCE CONCUSSION neuropsychology experts in the identification of specific persistent problems with brain function, should they occur. If a baseline cognitive test has been performed, post-injury performance is compared with pre-injury testing to monitor recovery and help guide a safe return to play, school, or work for the individual patient.
Changes in behavior and mood are well documented effects of concussion and can include impulsivity, defiance, low frustration tolerance, or changes in relationships and friendships. Irritability, depression, anxiety and mood swings are also commonly experienced symptoms of concussion. Physical or cognitive symptoms of concussion which persist for prolonged periods beyond the 2-3 weeks in which most concussions would be expected to resolve, can also result in depression, fear, and anxiety. Managing a concussion in a child or loved one can be challenging for family members and partners, and the coping and strength of the support network for a concussion patient can impact their recovery as well. ADVANCE CONCUSSION health psychology experts have a unique understanding of the impact of emotional functioning on recovery from conditions such as concussion and, therefore, assess and monitor the emotional and psychological functioning of concussion patients and their loved ones . When needed, expert support services are provided, for patients and their families, to help with coping and adjustment to injury.
Balance problems, postural instability, and dizziness are common symptoms following concussion, affecting almost half of all those who suffer concussive injuries and have been reported to last for years post-concussion. Vestibular rehabilitation at ADVANCE CONCUSSION involves assessment and treatment of neurological, inner ear and other conditions arising from concussion which control the individual’s sense of balance and positioning, and has been successfully implemented by our vestibular rehabilitation experts using specific exercises or manipulations in the treatment of balance and dizziness issues which do not resolve spontaneously or with rest alone.
Visual dysfunction is common occurrence following brain injury and has been shown to affect up to 90% of all individuals. Disturbances in vision can profoundly effect a person’s physical abilities and negatively impact daily functioning, causing issues with balance, spatial awareness, driving, and other safety hazards. If not identified or treated in a timely and clinically appropriate manner, visual dysfunction can contribute to persistent headaches, difficulty with reading or attention and concentration difficulties, as well as other symptoms of concussion. Therefore, screening and treatment of visual dysfunction is incorporated early in the ADVANCE CONCUSSION rehabilitation process to provide appropriate intervention during the optimal treatment window. Ocular-Motor or Visual therapy involves assessment and treatment of the ways your eyes work together to do things like focus on a target, keep focus while moving your head, shift from one target to another, or track images across a visual field, and are carefully performed under the careful guidance by ADVANCE CONCUSSION visual rehabilitation experts to work within symptom tolerance levels.
Exertion Based Physiotherapy
Consistent with current research and proven models of successful post-concussion rehabilitation , a structured, individualized, graded exercise program is developed considering the particular sport, age and concussion history of the individual patient. This involves progressively and gradually increasing physical activity or exertion under close supervision and guidance of ADVANCE CONCUSSION exertion specialists so that the concussion patient can tolerate more activity for longer periods of time without worsening symptoms. Sports or activity-specific challenges are added to these programs when appropriate.
Neck injury, whiplash, and other cervical spine injuries commonly occur at the same time as a concussion but are often overlooked. These injuries can result in symptoms that overlap with or are identical to symptoms of concussion. Headaches, dizziness, nausea, balance problems, tinnitus, and ear or eye pain can be associated with cervical spine injury and neck pain. Careful assessment of cervical function is performed by ADVANCE CONCUSSION physiotherapy experts and, when indicated, is treated in conjunction with other indicated areas of rehabilitation to maximize recovery outcomes.