Tag Archives: RTP Protocol

Good Reminder About Rest After Concussion

13 Nov

This blog post was made a while back, from time-to-time I will republish them with associated comments that resulted.  This topic is about “rest” after the injury.  Most if not all medical professionals now prescribe this method, but as we found out in Zurich recently, the research behind exactly what “rest” is and for how long is unknown.  What is known allowing the brain to settle down for a period of time is highly beneficial.

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Although most point to physical rest as the major component of concussion management the truth of the matter is that all activity that affects brain activity needs to be limited after a concussion.  If we use the “snow globe” analogy; all the flakes in the globe must come to rest before exposing it to further activity.  What excites the “flakes” or brain, honestly, just waking up does this.  That is why I have been hammering on the need for COMPLETE rest after a concussive episode.  It is also why I am a firm believer in getting kids out of school while the brain injury heals.

This information is not new to you that read the blog, but it seems that this management technique is just catching on as a principal protocol, rather than using it if there are setbacks;

“There is so little we really know about concussions,” said Dr. Mary Dombovy, vice president of Unity Neurosciences, which includes physical medicine and rehabilitation, neurology and neurosurgery. “We’re learning more as time goes by. What we’re learning is it’s not just physical exertion that is making the brain work harder. School tasks, studying for tests, trying to write a paper, these things are very stressful for people who’ve had a concussion.”

It is not that it is stressful, per se, it is that the brain is FUNCTIONING to do those tasks and like getting on crutches for a broken leg, the only way to get the brain on “crutches” is to not give it any stimulation.  Along with that comes how long and what to do when symptoms have gone, to me it is obvious that this is where you then begin the Zurich RTP protocol (the current concussion management protocol I use).

What I am having a hard time fathoming is Continue reading

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Family Travels Long Road of Recovery – TCB Suggestion

28 Feb

Brooke de Lynch of Mom’s Team sent over this article and video about a family and their dealings with post-concussion syndrome and the long recovery after a very “innocent” looking hit.  It begins as most complex cases often do, with incorrect initial management;

On the evening of Friday, February 12, 2010, my then 15-year-old daughter Heidi was hit on the head by the stick of a teammate as she was warming up in goal before a hockey game.

It was not a catastrophic brain injury requiring a trip by ambulance to the hospital. But the blow did result in a concussion; one that turned out to be far more severe, complicated and long-lasting than initially thought.

Because multiple mistakes were made in the immediate aftermath of the injury by all parties – including by me, her mother – which exacerbated her symptoms, that cold winter’s night marked the beginning of what would turn out to be a fourteen-month long search for answers to the enigmatic riddle that is post-concussion syndrome.

Another great perspective from a mom, this time about a girls hockey player.

Listen, all cases are not as drawn out like this one, in fact stats tell us that some 75-90% of all cases of mTBI/concussion recover in 7-10 days.  Remember that the “recover” portion of that last sentence is from symptoms AT REST.  This brings me to my soap box moment of the day… Continue reading

Return-to-Play Test?

1 Jul

Perhaps.  University of Buffalo doctors and researchers believe that they may have a tool that can provide definitive answers and take the “chance” out of the impending second injury.  John J. Leddy, MD, Karl Kozlowski, PhD and Barry Willer, PhD are authors of a study aimed at just doing that;

University at Buffalo researchers have developed a test to determine when it’s safe for athletes to return to play after a concussion.

Currently no standardized method exists to assess when the time is right. It is usually a judgment call made by team physicians.

“We believe this new approach could change the way professional and amateur sports team physicians make decisions about concussion recovery.”
Barry Willer, PhD
professor of psychiatry and rehabilitation medicine and senior author on the paper

The treadmill test devised by UB concussion specialists in the Department of Orthopedics could change that by providing a systematic approach to evaluate readiness.

“In the past, how a team physician and trainer made this decision was left to chance,” says Barry Willer, PhD, professor of psychiatry and rehabilitation medicine.

Willer is senior author of a paper titled Reliability of a Graded Exercise Test for Assessing Recovery from Concussion, published in the Clinical Journal of Sport Medicine.

Using the Balke standardized treadmill test the subjects were taken to either symptom exacerbation or perceived exhaustion.  Starting Continue reading

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