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Most clinical guidelines for concussion are based on athletes and rehabilitation protocols developed for this population. The general consensus is that 80-90% of injuries will recover in the first 1-2 weeks. Most of the evidence to support this statement, however, comes from senior athletes. Furthermore, much of the evidence in this population is due to the use of self-reported symptoms, and the validity of self-reported measures in athletes is poor, as they often underestimate symptoms in order to get back to exercise faster. When applied to a general population, some evidence suggests that self-reported symptoms in a general population did not reflect objective equilibrium data.
Instead of or in addition to self-reported result measures, clinical result measures are often used to quantify the effect of a concussion. Often times, BESS and C-O-P are sued with posturographic measures as this strikes a strong balance between cost effectiveness and validity and reliability.
The aim of the Toronto Concussion Study was to determine the restoration of longitudinal posture control after a concussion in adults in shared apartments using the BESS score and posturographic measures. It was hypothesized that an improvement in all measures is observed 2 weeks after the injury and persists over an observation window of 12 weeks. In this exploratory study, recovery was determined using a hierarchical growth curve model (HGCM).
The total sample size varied from week to week with week 1 n = 61, week 2 n = 58, week 4 n = 58, week 8 n = 51, week 8 n = 51 and week 12 n = 39. Between week 4 and 8 recovered self-reported outcome measures, but objectively less than 43% of participants improved beyond their performance in week 1.
Clinical effects
Not much work has been done to investigate the long-term recovery pathways of equilibrium performance in the general population after a concussion. Further work is definitely required. However, the results of this 12-week longitudinal study show that recovery is variable and does not follow a well-defined course. It can also be said that recovery in the general population differs from an athletic / athletic background, suggesting that different rehab protocols or approaches to rehab should be different.
Concussion program
Concussions lead to a constellation of physical, cognitive, visual, emotional and sleep-related disorders. In order to assess and treat concussions, we need to understand the mechanism of injury and the macroscopic and microscopic events that occur with the brain. We also need to understand the anatomy and function of the peripheral and central vestibular systems, as well as the various systems that affect posture control. This course program addresses these needs and their relationship to subjective and objective examination and physiotherapeutic management of concussions.
Recognition, evaluation and treatment of concussion injuries
