4 responses to “Concussion rehabilitation update and a free self-management concussion tool”

  1. Good information.
    Too bad there is so much duplication amongst some of the services

  2. excellent article,

    I am particularly interested in management for patients who are symptomatic for many months or years after their concussion – are more investigations, med trials other rehab measures relevant?

  3. Any guidance for increasing cognitive demands?

    Task for 30 mins then a rest period. Repeat if no Sx exacerbation….

    If all good increase when? 2 days? A week?

  4. Thank you for the responses. For Judith’s question, for clients who are experiencing prolonged symptoms for months or years after their concussion, prioritizing the management of sleep, mood and pain/headache is particularly important. Depending on the prolonged symptoms, this may entail medication trials if warranted and may involve further treatment from other members of the rehab team. For recommendations on the management of each symptom area, the ONF guidelines is an excellent tool: https://onf.org/3rd-edition-guidelines-for-concussion-mild-traumatic-brain-injury-and-persistent-symptoms/

    Regarding increasing cognitive demands, please see MyGuide’s section on thinking skills for more information: https://concussion.vch.ca/cognitive-function-thinking-skills
    It is recommended to gradually increase activities by frequency first, then duration, and lastly intensity. If working on a cognitively demanding task for 30 minutes (plus a brain break) is tolerable, this could be repeated. Once confident with the increased frequency, the length of task could be increased, and lastly increasing intensity or the amount of concentration it requires. Aiming to be in the “therapeutic zone” whereby activities are challenging but doable. For practical steps on gradually returning to activities and pacing: https://concussion.vch.ca/gradual-return-to-activities

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