Concussion Care Considerations
Did You Know?
Evidence Based Medical Guidelines DO NOT recommend putting patients in cervical rehab programs until there is relative certainty that there is no mTBI as exercise early in a concussion care can make symptoms worse.
Evidence Based Medical Guidelines DO recommend Electroencephalography (EEG) and Event Related Potential (ERP) for use in the evaluation of TBI patients.
MaDPI simply presents information for review and makes no recommendations regarding specific treatment modalities or protocols.
Treatment of Post-Concussion Syndrome
Most people with post-concussion syndrome are able to recover with rest and by minimizing stress. Most health care providers will also treat symptoms of post-concussion syndrome. For example, migraine or pain medications may be prescribed for those with headache. A specialist such as a neurologist and/or psychiatrist may also be involved to treat mental health symptoms associated with post-concussion syndrome. Antidepressants and psychotherapy may be recommended.
Studies show that manipulation and exercise are effective modalities for treating disorders associated with concussion such as whiplash. Due to the neurological implication of concussion referral to appropriate medical specialists may be recommended. When appropriate or medically advised active care or physical rehabilitation programs as well as cognitive rehabilitation programs should be considered after a suitable rest period if symptoms improve but still linger often past 2-4 weeks. Though many doctors may not be equipped to provide cognitive rehabilitation services and might consider referral to a neurologist, neuropsychologist or other appropriate health care professionals most should already be able to provide in-office physical rehabilitation since it is one of the most important and ubiquitous recommendations of evidence based medical guidelines (ACOEM, ODG, etc.) and medical literature for whiplash associated disorders. Engaging the patient in active participation in their own recovery including positive goal setting is now deemed critical to optimal outcome. Some of the more effective active care programs for Whiplash Associated Disorders (WAD) include therapeutic exercise and neuromuscular re-education provided in-office initially then at home if the patient is capable and properly motivated. These programs can include at a minimum neuromuscular re-education for proprioceptive training for balance (CPT 97112), aerobic training for endorphin release and overall strengthening and ROM exercises (CPT 97110). These modalities are beneficial for the musculoskeletal recovery of the injury victim.