We have all heard the word “concussion”. It is used commonly when speaking about collegiate and professional athletes. But, do you know what a concussion really is? A very serious condition, a concussion is a traumatic brain injury. Sustaining one can cause major changes, some short lasting and others considerably longer. A concussion happens when the brain is involved in any impact that causes a rapid back and forth movement. Oftentimes, we associate concussions with sports such as football and soccer, however athletes are not the only population who may be affected by concussions. According to the CDC, falls and motor vehicle accidents continue to be the leading causes of traumatic brain injury in the United States.
There are many signs and symptoms that may lead to thinking one has a concussion. The traditional symptoms are dizziness and headaches, however, as research increases in the area of concussions and mild brain injury we are learning there may be other symptoms that can affect a person’s daily routine tremendously. The visual system, which can use over 60% of the brains neural connections, can be severely impacted from a concussive blow leading sufferers to display symptoms such as poor tracking, light sensitivity, as well as double and blurred vision. These symptoms can cause difficulty with reading, work-related tasks, watching television, and more. Physical symptoms, including poor balance and decreased coordination can also be present, causing trouble with basic daily activities such as carrying groceries, doing laundry, and driving. Lastly, many researchers are now finding an increase in emotional changes post- concussion, such as depression, increased anxiety, and high irritability. These emotional discrepancies have been shown to increase the severity of headaches and prolong the recovery period in some patients.
Successful treatment of concussion requires an interdisciplinary approach from a wide range of healthcare practitioners. Physical and occupational therapists can play a large role in the recovery process in an outpatient clinic setting. Offering outpatient treatment, including vestibular rehabilitation to address balance and body orientation have proved helpful in regaining balance, and mitigating headaches and dizziness. Inclusion of visual motor exercises and activities is proving to assist with focus, attention, fatigue, and reducing headaches by increasing visual strength and endurance. Therapists can use a wide variety of assessments to address post-concussive patient needs such as the Vestibular Oculomotor Screening assessment, which utilizes a series of eye movements to measure increases in dizziness, fogginess, headache, and nausea, which are indicative of oculomotor dysfunction. Using results from this assessment, therapists can prescribe visual exercises such as smooth pursuits, vertical and horizontal saccades, and tracking to increase oculomotor endurance. Another commonly used assessment for vestibular rehabilitation is the Balance Error Scoring System (BESS test). This assessment measures static postural stability on even and uneven surfaces to see where patients may have deficits with balance. With these results the therapist can recommend exercises such as single leg stands and tandem balance on the ground or foam pads to help patients recover their balance. Eventually these tasks can be made more challenging by including activities such as ball tosses while balancing.
Overall, concussive injuries are to be taken very seriously. As we continue to learn more about the nature of concussions, we gain additional insight into the possible underlying effects that may accompany them. Anyone involved in an incident leading to experiencing symptoms should seek medical attention. This may include being referred to physical or occupational therapy to help address issues not able to be treated by a physician.
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