Concussion Office Based Rehabilitation Assessment: A Novel Clinical Tool for Concussion Assessment and Management

Abstract

The Concussion Office Based Rehabilitation Assessment (COBRA) is a novel tool constructed to ensure a comprehensive assessment of patients who may have sustained a concussion. The SCAT-5 (Sport Concussion Assessment Tool) has long been the gold standard for concussion assessment, however, it was designed as a sideline tool and its utility can be seen to decrease after a few days post-concussion. It also does not prompt evaluation of all the phenotypes of concussion. As such, the COBRA was created to assess the majority of potential manifestations of concussion in the office setting a day or two after an injury has been sustained. The COBRA utilizes the eight phenotypes of concussion as a guide to assess each of the potential biopsychosocial features that can be associated with these injuries and can be used to guide evidence-based treatments. Through early identification of concussion phenotypes, the clinician may start optimal treatment and hopefully prevent prolonged recovery and persisting symptoms.

Athlete Fear Avoidance, Depression, and Anxiety Are Associated with Acute Concussion Symptoms in Athletes

“…The SCAT5 is the gold standard test for the on-field immediate measurement of the concussion [19]; however, as indicated above, the variability in symptoms makes the assessment a challenge [8]. To our knowledge, no previous study has investigated the impact of pain-related fear, catastrophizing, and depression on the acute, on-field measure of concussion within 24-48 h after injury.…”