Active Treatment and Rehabilitation Approaches for Concussion

Experts from UPMC Sports Medicine discuss active treatment and rehabilitation approaches for concussion as part of UPMC's 2013 conference "Emerging Frontiers in Concussion."

Educational objectives:

Upon completion of this activity, participants should be able to:

• Discuss the medical management of post-concussion syndrome in the areas of sleep dysregulation, mood disorders, and cognitive difficulties, as well as different types and causes of post traumatic headaches.
• Define the five stages of exertion therapy.
• Identify common vestibular abnormalities following concussion
• Review  rehabilitation strategies to treat vestibular deficits

Reading Resources:

1. Gail B., Parkhouse WS, Goodman D. Exercise following a sport induced concussion. British Journal of Sports Medicine. 2004; 38: 773-777.
2. Geurts AC, Ribbers GM, Knoop JA, van Limbeek J. Identification of static and dynamic postural instability following traumatic brian injury. Arch Phys Med Rehabili. July 1996; 77(7):639-644.
3. Guskiewicz KM. Postural stability assessment following concussion: one piece of the puzzle. Clin J Sport Med. Jul 2001;11(3): 182-189.
4. Heikkila H, Johansson M, Wenngren Bl. Effects of acupuncture, cervical manipulation, and NSAID therapy on dizziness and impaired head repositioning of suspected cervical origin: a pilot study. Man Ther. Aug 2000; 5(3):151-157.
5. Jull G, Falla D, Treleaven J, Hodges P, Vicenzino B. Retraining cervical joint position sense: the effect of two exercise regimes. J Orthop Res. Mar 2007;25(3):404-412.
6. Kristjansson E, Treleaven J. Sensorimotor function and dizziness in neck pain: implications for assessment and management. J Orthop Sports Phys Ther. May 2009;39(5):364-377.
7. Camiolo-Reddy, Collins, Lovell, Kontos, JHTR, 2012
8. Hillier SL, Hollohan V. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2007(4):CD005397.
9. Brown KE, Whitney SL, Marchetti GF, Wrisley DM, Furman JM. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil. Jan 2006;87(1):76-81.
10. Whitney SL, Wrisley DM, Brown KE, Furman JM. Physical therapy for migraine-related vestibulopathy and vestibular dysfunction with history of migraine. Laryngoscope. Sep 2000;110(9):1528-1534
11. Alsalaheen BA, Mucha A, Morris LO, et al. Vestibular Rehabilitation for Dizziness and Balance Disorders After Concussion. Journal of Neurologic Physical Therapy. 2010;34:87-93.
12. Naguib MB, Madian Y, Refaat M, Mohsen O, El Tabakh M, Abo-Setta A. Characterisation and objective monitoring of balance disorders following head trauma, using videonystagmography. J Laryngol Otol. Jan 2012;126(1):26-33.

Disclosures:

Dr. Cara Troutman-Enseki has no relevant relationships with any entities producing health care goods or services.

Dr. Kelly Anderson has financial interests with the following any entity or entities producing health care goods or services as indicated below:

• Other: Impact - Speaker on medication management of concussion

Dr. Anne Mucha has financial interests with the following any entity or entities producing health care goods or services as indicated below:

• CE Speakers’ Bureau: Impact Applications

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 4/4/2014 | Last Modified On: 4/4/2014 | Expires: 4/4/2015