Rehabilitation of Concussion and Persistent Postconcussive Symptoms

Charles G. Wilber; John J. Leddy; Itai Bezherano; Lacey Bromley; Amanda E. Edwards; Barry S. Willer; Mohammad N. Haider

doi:10.1055/s-0041-1725134

Seminars in Neurology, Table of Contents

Semin Neurol 2021; 41(02): 124-131
DOI: 10.1055/s-0041-1725134

Review Article

Rehabilitation of Concussion and Persistent Postconcussive Symptoms

Charles G. Wilber

¹Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, UBMD, State University of New York at Buffalo, Buffalo, New York

,

John J. Leddy

¹Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, UBMD, State University of New York at Buffalo, Buffalo, New York

,

Itai Bezherano

¹Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, UBMD, State University of New York at Buffalo, Buffalo, New York

,

Lacey Bromley

²Department of Physical Therapy, School of Health Professions, D'Youville College, Buffalo, New York

³Bennett Rehabilitation Institute, Buffalo, New York

,

Amanda E. Edwards

⁴UB Counseling Services, Department of Athletics, State University of New York at Buffalo, Buffalo, New York

,

Barry S. Willer

⁵Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York

,

Mohammad N. Haider

¹Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, UBMD, State University of New York at Buffalo, Buffalo, New York

⁶PhD Program in Biomedical Science, Program of Neuroscience, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York

› Author Affiliations

Abstract

Concussion and persistent postconcussive symptoms (PPCS) are encountered by clinicians in sports medicine, pediatrics, neurology, physiatry, emergency medicine, and primary care. Clinical management may require a multidisciplinary approach. This article presents a structured method for the diagnosis of concussion and PPCS in the outpatient setting, which includes a history, physical examination, and additional tests as clinically indicated to help identify underlying symptom generators. Treatment for concussion and PPCS should be individualized, based on predominant signs and symptoms, and can include subsymptom threshold aerobic exercise, cervical physical therapy, vestibulo-ocular rehabilitation, behavioral and cognitive psychotherapy, and some symptom-specific pharmacological therapies.

Keywords

concussion - persistent post concussion symptoms - post-concussion syndrome - cervicogenic headache - active rehabilitation

Full Text

References

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