Taking An Evidence-Based Approach To Treating Post-Concussion Symptoms
Evidence indicates that beyond the acute phase of concussion recovery (i.e., within the first few days following injury), prolonged cognitive and physical rest can contribute to persisting symptoms. A growing body of literature suggests that physical inactivity alone, especially in previously highly active individuals, is associated with fatigue, depression, anxiety, and physical deconditioning.
Complex persisting post-concussion symptom etiology (i.e., a range of symptoms across a wide domain of functions) suggest that a multimodal rehabilitative approach is advantageous to assisting affected individuals in resuming their daily roles and responsibilities.
GRADED EXERCISE THERAPY
Advancements in research suggest that graded exercise therapy (GXT) is beneficial to alleviating persisting post-concussion symptoms exacerbated by physical activity. Supervised exertion training, while working within the bounds of an individual's sub-symptom threshold, is central to this approach.
VESTIBULAR & OCULAR THERAPY
Persisting symptoms associated with impairments to the vestibular-ocular system are thought to be among the most debilitating (i.e., dizziness, light-headedness, gait instability) concussion symptoms. Vestibular therapy has been shown to be an effective approach to improving vestibular and ocular function following concussion.
COGNITIVE BEHAVIOUR THERAPY
The presence of pre- and/or post-injury depression or anxiety symptoms have been shown to negatively impact functional recovery following concussion. Screening for and treating the symptoms of depression and/or anxiety can be helpful in facilitating recovery and improving an individual's quality of life.
MINDFULNESS & MINDFUL MEDITATION
Research shows that wandering minds are unhappy minds. The body of literature also shows that repeated bouts of meditation are associated with structural changes in the grey matter of the brain. Mindfulness can be an effective approach to reducing stress, boosting our coping and resiliency skills, improving our sleep as well as our self-esteem.
WHAT IS A CONSULTATION?
A consultation allows me to take an in-depth look at your medical history and the events related your recent concussion. We will have a detailed conversation about the issues and symptoms you are currently experiencing. We will also work together to set treatment goals and expectations. This appointment will range between 1 and 1.5 hours, so make sure you are well rested. You will also be required to fill out several forms, which you can complete beforehand if you like; I am happy to assist you with this process if your persisting symptoms are impeding you from completing this task. The primary focus of this appointment is to understand the origin of your symptoms and formulate our treatment plan.
WHAT SHOULD I BRING?
Please be sure to bring contact information for your general physician and any other healthcare practitioner you are currently working with to manage your persisting symptoms. A collaborative, multi-discipline approach is necessary to ensure that you are receiving the best possible care. If you are facing difficulties with light or noise sensitivity, please bring a pair of sunglasses and/or ear plugs. I will have some on hand in the case that you forget. If you have a heart rate monitor (i.e., FitBit, Apple Watch) you can bring that along as well. We can calibrate my monitor to yours when setting your sub-symptom threshold heart rate. It is also recommended that you bring your own pair of headphones and optical aids (i.e., reading glasses, glasses for distance, etc.), if you require them.
WHAT SHOULD I WEAR?
We will establish your exertional symptom threshold at this appointment, so you should prepare to be active. Please bring sports attire including: running shoes, shorts and/or active bottoms, sport top, any assistive devices that you require (i.e., braces, supports), and water bottle.
WHAT HAPPENS AFTER MY CONSULTATION?
Following your consultation appointment, I will compile my clinical assessment notes and forward them to you for review. At this point we will work together to establish how you'd like to proceed with your therapy, and begin to organize your follow-up sessions and at-home exercises. I will also be asking you to monitor your symptoms, and which activities (i.e., reading, grocery shopping, driving, etc.) you find help or hinder your daily functioning.
Please note, additional costs are associated with adding these services on to your standard care.
BRING A BUDDY
Ask a family member or team mate to join you at your session. These sessions will focus on partner-based exercises and activites.
I will join you at your sport practice location (e.g., rink, field, court). The focus here is to integrate you back into your sport. There is a heavy emphasis on sport-specific drills and skills.
I will work with your employer, school, or sports club to ensure appropriate accommodations are made while you're on your road to recovery.