An innovative approach to measuring youth concussion recovery: Occupational performance

Abstract

Introduction Concussion is a common injury in youth. Studies report that active rehabilitation interventions reduce symptoms in these youth. There is no literature that addresses its impact on occupational performance. The purpose of this study was to identify: (a) occupational performance issues experienced by these youth; (b) changes in occupational performance and satisfaction following participation in a 6-week active rehabilitation intervention; and (c) the relationship between changes in occupational performance and symptoms. Method As part of a larger prospective repeated measures study, measures of occupational performance (Canadian Occupational Performance Measure) and self-reported symptoms (Post-Concussion Symptom Inventory) were collected pre and post intervention. Paired t-test, Spearman correlation, and descriptive analyses were conducted. Results Youth (9–18 years; n = 52) reported a range of occupational performance issues in self-care, productivity, and leisure domains. The most frequently reported occupational performance issues were sport (32.70%) and school (31.75%) activities. Positive changes were found in both performance and satisfaction of occupational performance issues post intervention ( p<.001). Correlation analysis revealed that as symptoms decreased, occupational performance improved ( rs = –.359, p = .020). Conclusion Using a measure of occupational performance may provide meaningful insight into the functional recovery of concussion, and can help identify targeted functional approaches to paediatric concussion management.

Tele-Active Rehabilitation for adolescents with concussion: a feasibility study

“…Improvements in symptoms and occupational performance reported by our participants are comparable to previous in-person active rehabilitation studies, 4 9–15 indicating that the intervention may have similar beneficial effects when delivered remotely. Performance improved across a variety of activities commonly limited by concussion, including sport/exercise, schoolwork and leisure hobbies.…”

“…Performance improved across a variety of activities commonly limited by concussion, including sport/exercise, schoolwork and leisure hobbies. 4 Tailored education and support were essential to ensuring individualisation of the intervention and extending beyond exercise to address activities that were meaningful to each participant. Indeed, two participants identified education/support as the most helpful component, which is consistent with previous work in which youth highlighted energy management strategies as essential to active rehabilitation.…”

“…1 Most adolescents are expected to achieve symptom resolution within 4 weeks postinjury. 1 2 However, a large subset (approximately 30%) continue to experience persistent physical, cognitive, emotional or sleep-related symptoms beyond 1-month following concussion 2 and may report disturbances in mood, 3 activity resumption 4 and quality of life. 5 Current guidelines recommend an active approach to concussion management involving gradual activity resumption after an initial 24-48 hours of rest postinjury.…”

“…7 Active rehabilitation programmes for adolescents involve aerobic exercise, [8][9][10][11][12][13][14][15][16] sport coordination drills, [9][10][11][12][13][14][15] balance exercises, 11 relaxation training [9][10][11][12][13][14][15] and/or concussion education and support. [9][10][11][12][13][14][15] Studies show that active rehabilitation improves symptoms, [8][9][10][11][12][13][14][15][16] mood, 10 occupational performance 4…”

“…Most adolescents are expected to achieve symptom resolution within 4 weeks postinjury 1 2. However, a large subset (approximately 30%) continue to experience persistent physical, cognitive, emotional or sleep-related symptoms beyond 1-month following concussion2 and may report disturbances in mood,3 activity resumption4 and quality of life 5…”