Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach
Historically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to schoo...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-08-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00136/full |
| _version_ | 1811254027680219136 |
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| author | Michael John Ellis John Leddy Barry Willer |
| author_facet | Michael John Ellis John Leddy Barry Willer |
| author_sort | Michael John Ellis |
| collection | DOAJ |
| description | Historically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to school and sports activities in the majority of athletes, an important proportion will develop persistent concussion symptoms characteristic of post-concussion syndrome (PCS). Recent advances in exercise science, neuroimaging, and clinical research suggest that the clinical manifestations of PCS are mediated by unique pathophysiological processes that can be identified by features of the clinical history and physical examination as well as the use of graded aerobic treadmill testing. Athletes who develop PCS represent a unique population whose care must be individualized and must incorporate a rehabilitative strategy that promotes enhanced recovery of concussion-related symptoms while preventing physical deconditioning. In this review we present our evolving evidence-based approach to evaluation and management of athletes with PCS that aims to identify the pathophysiological mechanisms mediating persistent concussion symptoms and guides the initiation of individually-tailored rehabilitation programs that target these processes. In addition, we outline the important qualified roles that multi-disciplinary healthcare professionals can play in the management of this patient population, and discuss where future research efforts must be focused to further validate this evolving pathophysiological approach. |
| first_indexed | 2024-04-12T16:59:56Z |
| format | Article |
| id | doaj.art-ef86ca49cd794192a1cff4e1651f53c4 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T16:59:56Z |
| publishDate | 2016-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ef86ca49cd794192a1cff4e1651f53c42022-12-22T03:24:05ZengFrontiers Media S.A.Frontiers in Neurology1664-22952016-08-01710.3389/fneur.2016.00136218296Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approachMichael John Ellis0John Leddy1Barry Willer2University of Manitoba/Pan Am ClinicUBMDUBMDHistorically, patients with sports-related concussion (SRC) have been managed in a uniform fashion consisting mostly of prescribed physical and cognitive rest with the expectation that all symptoms will spontaneously resolve with time. Although this approach will result in successful return to school and sports activities in the majority of athletes, an important proportion will develop persistent concussion symptoms characteristic of post-concussion syndrome (PCS). Recent advances in exercise science, neuroimaging, and clinical research suggest that the clinical manifestations of PCS are mediated by unique pathophysiological processes that can be identified by features of the clinical history and physical examination as well as the use of graded aerobic treadmill testing. Athletes who develop PCS represent a unique population whose care must be individualized and must incorporate a rehabilitative strategy that promotes enhanced recovery of concussion-related symptoms while preventing physical deconditioning. In this review we present our evolving evidence-based approach to evaluation and management of athletes with PCS that aims to identify the pathophysiological mechanisms mediating persistent concussion symptoms and guides the initiation of individually-tailored rehabilitation programs that target these processes. In addition, we outline the important qualified roles that multi-disciplinary healthcare professionals can play in the management of this patient population, and discuss where future research efforts must be focused to further validate this evolving pathophysiological approach.http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00136/fullPost-Concussion SyndromeTreatmentManagementmulti-disciplinaryAthleteSports-related concussion |
| spellingShingle | Michael John Ellis John Leddy Barry Willer Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach Frontiers in Neurology Post-Concussion Syndrome Treatment Management multi-disciplinary Athlete Sports-related concussion |
| title | Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach |
| title_full | Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach |
| title_fullStr | Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach |
| title_full_unstemmed | Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach |
| title_short | Multi-disciplinary management of athletes with post-concussion syndrome: an evolving pathophysiological approach |
| title_sort | multi disciplinary management of athletes with post concussion syndrome an evolving pathophysiological approach |
| topic | Post-Concussion Syndrome Treatment Management multi-disciplinary Athlete Sports-related concussion |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00136/full |
| work_keys_str_mv | AT michaeljohnellis multidisciplinarymanagementofathleteswithpostconcussionsyndromeanevolvingpathophysiologicalapproach AT johnleddy multidisciplinarymanagementofathleteswithpostconcussionsyndromeanevolvingpathophysiologicalapproach AT barrywiller multidisciplinarymanagementofathleteswithpostconcussionsyndromeanevolvingpathophysiologicalapproach |