A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes
Sport-related concussion is an important condition that can affect collegiate and professional athletes. Expert consensus guidelines currently suggest that all athletes who sustain acute concussion be managed with a conservative approach consisting of relative rest and gradual resumption of school a...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2018-12-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.01115/full |
| _version_ | 1818998526859804672 |
|---|---|
| author | Michael J. Ellis Michael J. Ellis John Leddy Dean Cordingley Dean Cordingley Barry Willer |
| author_facet | Michael J. Ellis Michael J. Ellis John Leddy Dean Cordingley Dean Cordingley Barry Willer |
| author_sort | Michael J. Ellis |
| collection | DOAJ |
| description | Sport-related concussion is an important condition that can affect collegiate and professional athletes. Expert consensus guidelines currently suggest that all athletes who sustain acute concussion be managed with a conservative approach consisting of relative rest and gradual resumption of school and sport activities with active intervention reserved for those with persistent post-concussion symptoms lasting >10–14 days for adults. Unfortunately, these recommendations place little emphasis on the rapid physical deconditioning that occurs in athletes within days of exercise cessation or the pathophysiological processes responsible for acute concussion symptoms that can be successfully targeted by evidence-based rehabilitation strategies. Based on our evolving approach to patients with persistent post-concussion symptoms, we now present an updated physiological approach to the initial medical assessment, rehabilitation, and multi-disciplinary management of collegiate and professional athletes with acute concussion. Utilizing the results of a careful clinical history, comprehensive physical examination and graded aerobic exercise testing, we outline how team physicians, and athletic training staff can partner with multi-disciplinary experts in traumatic brain injury to develop individually tailored rehabilitation programs that target the main physiological causes of acute concussion symptoms (autonomic nervous system dysfunction/exercise intolerance, vestibulo-ocular dysfunction, and cervical spine dysfunction) while maintaining the athlete's physical fitness during the recovery period. Considerations for multi-disciplinary medical clearance of collegiate and professional athletes as well as the application of this approach to non-elite athletes are also discussed. |
| first_indexed | 2024-12-20T22:02:56Z |
| format | Article |
| id | doaj.art-d064ddaf6087440ba0110278a8cb0a52 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T22:02:56Z |
| publishDate | 2018-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-d064ddaf6087440ba0110278a8cb0a522022-12-21T19:25:18ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-12-01910.3389/fneur.2018.01115423175A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional AthletesMichael J. Ellis0Michael J. Ellis1John Leddy2Dean Cordingley3Dean Cordingley4Barry Willer5Section of Neurosurgery, Department of Surgery, Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, Canada North Concussion Network, University of Manitoba, Winnipeg, MB, CanadaPan Am Concussion Program, Winnipeg, MB, CanadaUBMD Department of Orthopaedics and Sports Medicine, Buffalo, NY, United StatesPan Am Concussion Program, Winnipeg, MB, CanadaPan Am Clinic Foundation, Winnipeg, MB, CanadaDepartment of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, United StatesSport-related concussion is an important condition that can affect collegiate and professional athletes. Expert consensus guidelines currently suggest that all athletes who sustain acute concussion be managed with a conservative approach consisting of relative rest and gradual resumption of school and sport activities with active intervention reserved for those with persistent post-concussion symptoms lasting >10–14 days for adults. Unfortunately, these recommendations place little emphasis on the rapid physical deconditioning that occurs in athletes within days of exercise cessation or the pathophysiological processes responsible for acute concussion symptoms that can be successfully targeted by evidence-based rehabilitation strategies. Based on our evolving approach to patients with persistent post-concussion symptoms, we now present an updated physiological approach to the initial medical assessment, rehabilitation, and multi-disciplinary management of collegiate and professional athletes with acute concussion. Utilizing the results of a careful clinical history, comprehensive physical examination and graded aerobic exercise testing, we outline how team physicians, and athletic training staff can partner with multi-disciplinary experts in traumatic brain injury to develop individually tailored rehabilitation programs that target the main physiological causes of acute concussion symptoms (autonomic nervous system dysfunction/exercise intolerance, vestibulo-ocular dysfunction, and cervical spine dysfunction) while maintaining the athlete's physical fitness during the recovery period. Considerations for multi-disciplinary medical clearance of collegiate and professional athletes as well as the application of this approach to non-elite athletes are also discussed.https://www.frontiersin.org/article/10.3389/fneur.2018.01115/fullacute concussionphysiologyassessmenttargeted rehabilitationcollegiate and professional athletes |
| spellingShingle | Michael J. Ellis Michael J. Ellis John Leddy Dean Cordingley Dean Cordingley Barry Willer A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes Frontiers in Neurology acute concussion physiology assessment targeted rehabilitation collegiate and professional athletes |
| title | A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes |
| title_full | A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes |
| title_fullStr | A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes |
| title_full_unstemmed | A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes |
| title_short | A Physiological Approach to Assessment and Rehabilitation of Acute Concussion in Collegiate and Professional Athletes |
| title_sort | physiological approach to assessment and rehabilitation of acute concussion in collegiate and professional athletes |
| topic | acute concussion physiology assessment targeted rehabilitation collegiate and professional athletes |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.01115/full |
| work_keys_str_mv | AT michaeljellis aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT michaeljellis aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT johnleddy aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT deancordingley aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT deancordingley aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT barrywiller aphysiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT michaeljellis physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT michaeljellis physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT johnleddy physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT deancordingley physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT deancordingley physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes AT barrywiller physiologicalapproachtoassessmentandrehabilitationofacuteconcussionincollegiateandprofessionalathletes |