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Concussion / Mild Traumatic Brain Injury Guide: Rehab & PCS / Return to Play

What is Post-Concussion Syndrome?

Post-concussion syndrome involves a subset of patients who are experiencing symptoms beyond expected healing rates. 

The World Health Organization defines PCS as a persistence of 3 or more of the following after head injury:

  • headache
  • dizziness
  • fatigue
  • irritability
  • insomnia
  • concentration difficulty
  • memory difficulty.

On the right are links to research articles involving new methods for resolving post-concussion syndrome.

Systematic Review of Prognosis and Return to Play After Sport Concussion

A review of current evidence, published between 2001 and 2012, surrounding prognosis and return to play guidelines. 

Citation: Cancelliere C, Hincapié CA, Keightley M, Godbolt AK, Côté P, Kristman VL, Stålnacke BM, Carroll LJ, Hung R, Borg J, Nygren-de Boussard C, Coronado VG, Donovan J, Cassidy JD. Systematic review of prognosis and return to play after sport concussion: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil. 2014 Mar;95(3 Suppl):S210-29. doi: 10.1016/j.apmr.2013.06.035. Review. PubMed PMID: 24581907.

 

Rehabilitation of Concussion & Post-Concussion Syndrome

This review of the research will assist practitioners with rehabilitation of patients who have suffered concussions, as well as those who are not progressing slowly. 

Citation: Leddy JJ, Sandhu H, Sodhi V, Baker JG, Willer B. Rehabilitation of Concussion and Post-concussion Syndrome. Sports Health. 2012 Mar;4(2):147-54. PubMed PMID: 23016082; PubMed Central PMCID: PMC3435903.

Cervicovestibular Rehabilitation in Sport-Related Concussion: a Randomised Controlled Trial

This study measures the effect that cervical spine and vestibular rehabilitation has on a patient with persistent concussion symptoms.

Citation: Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, Emery CA. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med. 2014 Sep;48(17):1294-8. doi: 10.1136/bjsports-2013-093267. Epub 2014 May 22. PubMed PMID: 24855132.

A Preliminary Study of Subsymptom Threshold Exercise Training for Refractory Post-Concussion Syndrome

This study was designed to evaluate the efficacy of subsymptom exercise training for those with a post-concussion symdrome diagnosis.

Citation: Leddy JJ, Kozlowski K, Donnelly JP, Pendergast DR, Epstein LH, Willer B. A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. Clin J Sport Med. 2010 Jan;20(1):21-7. doi:10.1097/JSM.0b013e3181c6c22c. PubMed PMID: 20051730.

 

Return to Full Functioning after Graded Exercise Assessment and Progressive Exercise Treatment of Postconcussion Syndrome

This article discusses the effect of exercise training on participants after a post-concussion syndrome diagnosis and their ability to return to normal physiological function, including autonomic balance and the improvement of cerebral blood flow autoregulation.

Citation: Baker JG, Freitas MS, Leddy JJ, Kozlowski KF, Willer BS. Return to full functioning after graded exercise assessment and progressive exercise treatment of postconcussion syndrome. Rehabil Res Pract. 2012;2012:705309. doi:10.1155/2012/705309. Epub 2012 Jan 16. PubMed PMID: 22292122; PubMed Central PMCID: PMC3265107.