Concussion Management

A concussion is caused by a direct or indirect blow or hit to the head, face, jaw or body. This causes the brain to accelerate then decelerate inside the skull which causes nerves (axons) in the brain to "stretch". This axonal stretching results in metabolic changes which create and "energy crisis" in the brain. During the first 7-10 days following a concussion, both physical and cognitive rest is essential to conserve energy and enable the brain to heal and recover.

Signs and symptoms of a concussion are broad and variable between individuals. The time line for recovery is also variable from person to person. If diagnosed early and managed properly, concussions can resolve in days to weeks. In some cases, however, concussions can persist for months even years.

Baseline Testing

A baseline test gives healthcare professional a "point of reference" or measure of an athlete's pre-season cognitive and physical function. In the event of a concussion, an athlete's post-injury function can be compared to baseline results. Having a baseline test helps determine the severity of injury, allows an objective measure to guide rehabilitation and is used to determine when an athlete is ready to safely return to play.

Baseline testing consists of 3 components to assess an athlete's cognitive and physical function.

Neurocognitive Testing (ImPACT)

ImPACT stands for Immediate Post Concussion and Cognitive Testing. ImPACT is the most widely used, scientifically validated, FDA approved computerized concussion test available. It is a computer based test that takes approximately 30 minutes to complete. The test comes in adult and pediatric versions and measures memory, reaction time, attention span and how quickly information is processed.

Balance and postural stability

Both balance and postural stability are affected following a concussion and are important measures to be assessed pre and post-concussion.

Vestibular Ocular Motor Screening (VOMS)

The visual system is often significantly impacted following a concussion. In most cases, visual acuity (clarity) is not affected but the ability of the eyes to work together in a coordinated manner is impaired. Screening visual coordination skills (VOMS) at baseline and post-concussion helps to identify these problems and direct the most appropriate treatment. Any individual that sustains a concussion should be assessed by their family doctor or pediatrician as soon as possible following injury. The next step is to book and appointment at the clinic to be assessed and begin the most appropriate treatment and management.