3 responses to “Concussion rehabilitation”

  1. I suffered a concussion Aug/14 in a MVA. A very long journey to recovery, sampled many “healing” pathways and want to report what it was that was most useful.
    ICBC organized a referral to an OT and I must say I was sceptical. “What could she teach me that I did not already know” I thought.
    Well, she taught me to pace (who knew it was so hard) and then held me accountable. I felt supported, she normalized my symptoms, insisted I attend a ERCS group in Coquitlam with my partner.
    It took me a year to get fully back to my life.
    I shall forever be thankful to that OT.

  2. I am very excited to see this common-sense, realistic report on this important topic. Thank you. I am concerned however that we need to do more than change the practice of a few docs. reading this excellent review.

    I understand that with concussion, 2 days “rest”is the recommended amount; then it’s about a “gradual resumption” to activities (8). Return to activities as soon as possible post-injury is of great importance, to reduce the risk of prolongation of recovery. Reassurance regarding the non-specific and non-threatening nature of symptoms often referred to as ‘post-concussion syndrome’ is of paramount importance; inappropriate medical follow-up and therapies may often provoke these very symptoms in anxious patients.

    This is not understood by many doctors and therapists, who advise longer periods of rest and interventions that promote anxiety and delay recovery, such as needless brain imaging and other investigations and treatments.

    The press contains advertisements from unscrupulous outfits that offer unproven ‘treatments’ for persons ‘living with concussion symptoms’. Others in the community have an interest in promoting an alarmist view of concussion as being invariably associated with persistent brain injury.

    With the uncertainty in qualified medical persons (due in part to a proliferation of inappropriate diagnostic and management guidelines for concussion), as well as the misinformation widely available from persons profiting from the fear that surrounds this diagnosis, a well-funded and widely distributed public information campaign is needed.

    I would recommend a series of advertisements in large and local newspapers over at least 6 months; a series of public talks throughout the province and a school and university lecture program.

    We are facing an epidemic, due to misinformation which is spreading a sense of panic in the public. As always, education is the answer.

  3. Thanks for choosing this important topic, especially since the evidence and guidelines have been rapidly changing in the past few years. As a family doc, I was interested to see new tools that I might be able to use, perhaps easier than the current tools I go to. When I opened the first link to ONF, my heart sank when I saw the massive document. When would I have time to read through this, absorb it, figure out how to incorporate it into my practice, recall it when I next need it….. When experts pull together comprehensive documents, the knowledge translation into action in primary care is often missing. I will also in the same day see patients with heart disease, children with fevers, dementia, addictions, cancers, etc. I have to change mental gears every 15 minutes (some docs more often than that). The kind of support that I need to do this is missing. Even just the basic use of the SCAT3 is daunting. Where will I put the 38 mm wide sports tape 3 m long in my clinic for the tandem gait testing. Where is my stop watch? Where do I store this tool and the instructions so I can grab it when I need it? How can I integrate it with my EMR?
    If I only treat concussion, or even sports injuries, this is less of a problem. That is not my reality.

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