Our regionally-recognized Concussion Rehabilitation and Therapy Program is led by concussion management leaders who are ImPACT Trained Physical Therapist (ITPT) credentialed. This team of subject experts have devised concussion-focused rehabilitation protocols to provide a comprehensive approach to concussion care. Our comprehensive program has direct collaboration with our Board-Certified Neurologist Dr. Sommer Ebdlahad. Our Neurologist will assist in providing proper conversations and documentation for careful reentry into schools and work environments. Additionally this program integrates critical data points from testing and evaluations to develop the most optimal and individualized treatment program. Our physical therapy concussion experts have extensive training to prescribe the latest research-based treatments for concussion patients who require treatment for their neck injuries, dizziness symptoms, balance difficulties, visual difficulties, and exercise intolerance challenges.
In addition to providing post-concussion treatments, our concussion experts provide baseline neurocognitive testing prior to a concussion. Baseline testing is important for all patients so post-concussion test scores can be compared to their baseline testing to determine the severity of each patient’s concussion and their recovery potential.
Call us at 703.709.1116 to schedule your appointment for concussion treatment, or schedule your baseline neurocognitive concussion test with Dr. Ebdlahad at 703.709.1114.
VTFC provides a comprehensive approach to treating concussions. There can be similar patterns of symptoms for patients with concussion, but each patient has their own unique presentation and therefore there is a need to provide specialized treatment for each concussion patient. The Concussion Rehabilitation and Therapy Program is tailored to the uniqueness each patient may present with their concussion, and provides a comprehensive assessment of concussion symptom presentations. From our in-depth comprehensive assessment we are able to properly identify problem areas and prescribe the optimal treatment plan for each concussion patient.
Assessment and treatment for concussion patients may occur in the following areas:
- Post-Traumatic Migraine
- Cervical / Neck Injuries
- Vestibular Therapy
- Ocular Therapy / Vision
- Exercise Intolerance
- Neurocognitive Testing
- Memory Difficulties
Recent studies suggest concussion injury reporting has more than doubled between 2007 and 2014. Athletes are at higher risk for concussions and there is a higher risk for female (23%) than males (17%) to sustain a concussion injury. The most common symptom for females is sleep disturbances and most common symptom for males is forgetfulness. Males and female have the same recovery time following a concussion injury. Nearly 80% of patients with concussion will have significant improvements within the first 3 weeks following a concussion. Neurocognitive testing, such as ImPACT testing, when performed 1-2 days following a concussion, can predict a delayed concussion recovery.
The 10 Most Common Symptoms Following Concussion are:
- Headache/Post-Traumatic Migraine
- Feeling Slowed Down
- Difficulty Concentrating
- Visual Blurring / Double Vision
- Light Sensitivity
- Memory Dysfunction
- Balance Difficulties
CONCUSSION THERAPY FOR Headaches/Post-Traumatic Migraine SYMPTOMS
Headaches are the #1 reported symptom following concussion and can include Post-traumatic migraines. Headaches can occur in isolation and can also occur in association with cervical (neck) injuries. The amount of force to cause a concussion is approximately 95 g-forces (g’s). However, the amount of force required to cause cervical whiplash is significantly lower at 4-8 g’s. As a result, injuries to the head and neck causing concussion often have injuries to the cervical spine. The injuries to the cervical spine resemble whiplash injuries that can occur in an automobile accident.
VTFC has been recognized as a leader in the physical therapy community for treating spinal disorders; more specifically treatment of the cervical spine and headaches. Our physical therapy experts have extensive training to biomechanically assess how the neck joints are moving and relate to one another. Headaches are often related to upper cervical dysfunction and can often successfully be treated with manual therapy techniques and trigger point dry needling. Once cervical biomechanical deficits are properly identified a combination of manual therapy, functional exercise and modalities are used to treat the dysfunctional areas. If physical therapy treatment is not effective for headaches then medication, prescribed by a physician, may be needed to assist the patient in their headache treatment.
CONCUSSION THERAPY FOR Dizziness and Balance and Vision Symptoms
The treatment of dizziness and balance disorders is commonly known as Vestibular Therapy. Many vestibular disorders, caused by concussion or other disorders, often cause relatable challenges in dizziness, balance, and vision. Specific physical therapy training is recommended to optimally prescribe Vestibular Therapy. Our VTFC Concussion Team Physical Therapists are Competency Certified Vestibular Therapists. Vestibular symptoms account for the #4 (Dizziness), #7 (Visual Blurring/Double Vision), and the #10 (Balance Difficulties) most common symptoms following concussion. After a concussion, the prevalence of ocular dysfunction can be profound and very disabling; causing blurred vision and difficulty reading. Near point convergence and accommodation are coordinated eye movements which are essential visual processes for clear vision. Convergence difficulties increase by 7X and eye accommodation difficulties increase by 3X following concussion.
Treatment of Vestibular, Balance, and Visual symptoms begin with our comprehensive evaluation. VTFC utilizes evidence-based testing tools specific to post-concussion assessment. Once deficits are identified specific Vestibular eye/head exercises are prescribed to improve clear vision, improve the Vestibular Ocular Reflex, improve a patient’s static and dynamic visual acuity, and reduce dizziness. Additional exercises are prescribed to challenge and improve the patient’s balance. We use research-tested techniques to improve a patient’s visual near point convergence and accommodation. Many Vestibular, Balance, and Vision exercises are prescribed as home exercise programs when our patients demonstrate the ability to perform the exercises correctly in the clinic.
CONCUSSION THERAPY FOR Exercise Intolerance / Inability to Exercise
Exercise intolerance is a condition of inability, or decreased ability, to perform physical exercise at what would be considered a normal or expected level or duration. It also includes experiences of unusually severe post-exercise pain, fatigue, nausea, vomiting or other negative effects. Exercise intolerance is a common component of post-concussion syndrome due to disruption of the sympathetic and parasympathetic balance of the Autonomic Nervous System (ANS) following an insult to the brain. Symptoms associated with exercise intolerance include typical concussion symptoms such as headaches, dizziness, fatigue, and brain fog during or after exercise. Exercise has been shown, through recent research, to be a vital part of a successful concussion program. In the past, exercise would not be prescribed until symptoms improved to a reasonable level. More recently, when prescribed correctly, exercise has been found to be essential to assisting the improvement of all categories of concussion symptoms. Proper exercise prescription is especially helpful in speeding up concussion recovery when an individual is not showing progressive improvement in their concussion-related symptoms.
VTFC utilizes evidence-based assessment protocols to evaluate a patient’s tolerance to exercise. Treatment of exercise intolerance at VTFC utilizes the latest technology to evaluate a patient’s symptom presentation while monitoring vital signs and their level of perceived exertion. We utilize these metrics, integrated with additional treatment measures, to prescribe optimal cardiovascular and resistance exercises. Patients are initially monitored in the clinic and then prescribed a home exercise program based on their compliance and exercise capacity.
How Do We Treat Concussion Symptoms Utilizing Neurocognitive Testing and Memory Difficulties?
Symptoms of feeling slowed down, difficulty concentrating, fogginess, and memory difficulties are the #2, #3, #5, and #9 most common symptoms following concussion. These symptoms are often interrelated. VTFC utilizes ImPACT Neurocognitive testing to determine areas of deficiency and improvement following concussion. Baseline ImPACT testing is very helpful, for individuals before they have a concussion, to use to determine the severity of their concussion and improvement with Concussion Treatment. In addition to ImPACT testing, we utilize CogMed software to evaluate and train memory difficulties with our concussion patients. CogMed is a program performed at home on a daily basis to assist in improving memory and brain training. CogMed has been found to be helpful in treating memory dysfunction in Post-Concussion syndrome patients.
Call us at 703.709.1116 to schedule your appointment for concussion therapy, or schedule your baseline neurocognitive concussion test with Neurologist Dr. Ebdlahad at 703.709.1114.