Concussion Science

 

  • A concussion, also called a traumatic brain injury, is an injury to the brain. This could happen through both physical trauma to the head, like being hit by a baseball or falling out of a tree, or by motion of the head, such as whiplash in a car accident.

    There are also “subconcussions,” which are less severe and don’t automatically register during most initial concussion assessments, but these subconcussions add up over time to equal the same trauma in the brain as a single direct concussion would.

  • Symptoms of concussions and subconcussions tend to show themselves in 4 categories:

    1) Physical: headaches, dizziness, light sensitivity, noise sensitivity, tinnitus, vision disturbances, balance problems, excessive fatigue, and more.

    2) Sleep: insomnia, sleep apnea, and changes in sleeping patterns are frequent.

    3) Psychologically/emotionally: depression, irritability, mood swings, hyperactivity, loss of libido, can all occur, too.

    4) Cognitive: memory problems, poor concentration, easily distracted, easily fatigued by mental tasks, and more.

  • “We got a CT scan, and it turned out fine.”

    Unfortunately, CT scans are not a good way to diagnose the majority of concussions. Instead, skilled concussion rehab therapists will use a combination of tests which measure physical and mental symptoms.

    These tests look at vision, vestibular (balance) problems, gait and motor control patterns, and patient questionnaires. Common concussion tests include the SCAT3, ImPACT, K-D, and DVAT, as well as gait and movement patterns.

    Research is now looking into the accuracy and sensitivity of blood tests to diagnose concussions, evaluating blood protein markers.

  • Concussion has been shown to be a factor in developing Alzheimer’s disease, Parkinson’s, stroke, epilepsy, and more.

    Even though the trauma or incident itself might have lasted less than a second, the inflammation and brain damage can last for decaes.

  • Brain mastery is how RESTAGE trains our clients to overcome concussions and subconcussions.

    RESTAGE focuses on the vision, vestibular (balance), cognitive, breathing, and exercise aspects of concussion rehab. The same movement mastery program we use can be tailored to fit concussion rehab needs, so with us, we’re killing two birds with one stone. It’s an entirely integrative process.

    Our practitioners tend to catch many undiagnosed concussions and subconcussions through our movement mastery program.

    You’ll find other concussion rehab programs will use a variety of other methods, too, such as pharmacological, hyperbaric oxygen, and rTMS (electromagnetic stimulation to the brain).

    Research is continuing every day to add new recovery protocols and clarify existing ones so we can evaluate the best options for our clients.

    The RESTAGE concussion program brings rehab to wherever you are as a client, to the level that is appropriate for your life, and in a way that you can succeed.

 

Sources

Alex P. Di Battista, Shawn G. Rhind, Andrew J. Baker, Rakesh Jetly, Jeff D. Debad, Doug Richards & Michael G. Hutchison (2018) An investigation of neuroinjury biomarkers after sport-related concussion: from the subacute phase to clinical recovery, Brain Injury, 32:5, 575-582, DOI: 10.1080/02699052.2018.1432892

Amir Hadanny & Shai Efrati (2016): Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions, Expert Review of Neurotherapeutics, DOI: 10.1080/14737175.2016.1205487

Bachynski K, Smoglia J. (2019) Pseudomedicine for sports concussions in the USA, The Lancet Neurology. doi.org/10.1016/S1474-4422(19)30250-9

Begasse de Dhaem, O., Barr, W.B., Balcer, L.J. et al. Post-traumatic headache: the use of the sport concussion assessment tool (SCAT-3) as a predictor of post-concussion recovery. J Headache Pain 18, 60 (2017). https://doi.org/10.1186/s10194-017-0767-5

Broglio, S. P., Kontos, A. P., Levin, H., Schneider, K., Wilde, E. A., Cantu, R. C., Feddermann-Demont, N., Fuller, G. W., Gagnon, I., Gioia, G. A., Giza, C., Griesbach, G. S., Leddy, J. J., Lipton, M. L., Mayer, A. R., McAllister, T. W., McCrea, M., McKenzie, L. B., Putukian, M., Signoretti, S., … Joseph, K. (2018). National Institute of Neurological Disorders and Stroke and Department of Defense Sport-Related Concussion Common Data Elements Version 1.0 Recommendations. Journal of neurotrauma, 35(23), 2776–2783. https://doi.org/10.1089/neu.2018.5643

Buhagiar Francesca, Fitzgerald Melinda, Bell Jason, Allanson Fiona, Pestell Carmela, Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review, Frontiers in Human Neuroscience, Vol 4, 2020, https://www.frontiersin.org/article/10.3389/fnhum.2020.598208

Ciuffreda, K. J., Yadav, N. K., & Ludlam, D. P. (2017). Binasal Occlusion (BNO), Visual Motion Sensitivity (VMS), and the Visually-Evoked Potential (VEP) in mild Traumatic Brain Injury and Traumatic Brain Injury (mTBI/TBI). Brain sciences, 7(8), 98. https://doi.org/10.3390/brainsci7080098

Ciuffreda, K. J., Yadav, N. K., & Ludlam, D. P. (2017). Binasal Occlusion (BNO), Visual Motion Sensitivity (VMS), and the Visually-Evoked Potential (VEP) in mild Traumatic Brain Injury and Traumatic Brain Injury (mTBI/TBI). Brain sciences, 7(8), 98. https://doi.org/10.3390/brainsci7080098

Cobb, E. (2021). Post-Concussion Rehabilitation. Z Health.

Eric A. Nauman, Thomas M. Talavage, Paul S. Auerbach, Mitigating the Consequences of Subconcussive Head Injuries, Annual Review of Biomedical Engineering 2020 22:1, 387-407

Fann JR, Burington B, Leonetti A, Jaffe K, Katon WJ, Thompson RS. Psychiatric illness following traumatic brain injury in an adult health maintenance organization population. Arch Gen Psychiatry. 2004 Jan;61(1):53-61. doi: 10.1001/archpsyc.61.1.53. PMID: 14706944.

Ferris, L. M., Kontos, A. P., Eagle, S. R., Elbin, R. J., Collins, M. W., Mucha, A., McAllister, T. W., Broglio, S. P., McCrea, M., Pasquina, P. F., & Port, N. L. (2022). Utility of VOMS, SCAT3, and ImPACT Baseline Evaluations for Acute Concussion Identification in Collegiate Athletes: Findings From the NCAA-DoD Concussion Assessment, Research and Education (CARE) Consortium. The American Journal of Sports Medicine, 50(4), 1106–1119. https://doi.org/10.1177/03635465211072261

Higgins G, 2022, personal communication.

Johnson, B., Neuberger, T., Gay, M., Hallett, M., & Slobounov, S. (2014). Effects of subconcussive head trauma on the default mode network of the brain. Journal of neurotrauma, 31(23), 1907–1913. https://doi.org/10.1089/neu.2014.3415

Joseph Clark, Kimberly Hasselfeld, Kathryn Bigsby, Jon Divine; Colored Glasses to Mitigate Photophobia Symptoms Posttraumatic Brain Injury. J Athl Train 1 August 2017; 52 (8): 725–729. doi: https://doi.org/10.4085/1062-6050-52.4.04

King, D., Gissane, C., Hume, P. A., and Flaws, M. (2015). The King-Devick test was useful in management of concussion in amateur rugby union and rugby league in New Zealand. J. Neurol. Sci. 351, 58–64. doi: 10.1016/j.jns.2015.02.035

Ledreux A, Pryhoda MK, Gorgens K, Shelburne K, Gilmore A, Linseman DA, Fleming H, Koza LA, Campbell J, Wolff A, Kelly JP, Margittai M, Davidson BS and Granholm A-C (2020) Assessment of Long-Term Effects of Sports-Related Concussions: Biological Mechanisms and Exosomal Biomarkers. Front. Neurosci. 14:761. doi: 10.3389/fnins.2020.00761

Marques P, 2022, personal communication.

McCrea M, Broglio SP, McAllister TW, et al. Association of Blood Biomarkers With Acute Sport-Related Concussion in Collegiate Athletes: Findings From the NCAA and Department of Defense CARE Consortium. JAMA Netw Open. 2020;3(1):e1919771. doi:10.1001/jamanetworkopen.2019.19771

Pfeiffer, S. (2021, December 23). Everyday people fear they have CTE. A dubious market has sprung up to treat them. NPR. Retrieved April 21, 2022, from https://www.npr.org/2021/12/23/1049814853/everyday-people-fear-they-have-cte-a-dubious-market-has-sprung-up-to-treat-them

Santos, A., Walsh, H., Anssari, N., Ferreira, I., & Tartaglia, M. C. (2020). Post-Concussion Syndrome and Sleep Apnea: A Retrospective Study. Journal of clinical medicine, 9(3), 691. https://doi.org/10.3390/jcm9030691

Theodoroff, Sarah M. PhD*,†; Papesh, Melissa AuD, PhD*,†; Duffield, Tyler PhD‡; Novak, Melissa DO‡; Gallun, Frederick PhD*,†; King, Laurie PhD*,‡,§; Chesnutt, James MD‡,§; Rockwood, Ryan ATC‡; Palandri, Marisa OT‡; Hullar, Timothy MD*,† Concussion Management Guidelines Neglect Auditory Symptoms, Clinical Journal of Sport Medicine: March 2022 - Volume 32 - Issue 2 - p 82-85 doi: 10.1097/JSM.0000000000000874

Walter AE, Wilkes JR, Arnett PA, Miller SJ, Sebastianelli W, Seidenberg P, Slobounov SM. The accumulation of subconcussive impacts on cognitive, imaging, and biomarker outcomes in child and college-aged athletes: a systematic review. Brain Imaging Behav. 2022 Feb;16(1):503-517. doi: 10.1007/s11682-021-00489-6. Epub 2021 Jul 26. PMID: 34308510.

Worts PR, Burkhart SO, Kim JS. A Physiologically Based Approach to Prescribing Exercise Following a Sport-Related Concussion. Sports Med. 2019 May;49(5):683-706. doi: 10.1007/s40279-019-01065-1. PMID: 30742254.

Ye Xiong, Asim Mahmood, Michael Chopp, Current understanding of neuroinflammation after traumatic brain injury and cell-based therapeutic opportunities, Chinese Journal of Traumatology, Volume 21, Issue 3, 2018, Pages 137-151, ISSN 1008-1275

Zhou, G., and Brodsky, J. R. (2015). Objective vestibular testing of children with dizziness and balance complaints following sports-related concussions. Otolaryngol. Head Neck Surg. 152, 1133–1139. doi: 10.1177/0194599815576720