Does Australia have a concussion ‘epidemic’?

Thomas, Elizabeth; Fitzgerald, Maria; Cowen, Gill

doi:10.2217/cnc-2019-0015

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…Global estimates suggest there are more than 50 million new cases of mTBI annually (Maas et al, 2017). However, accurately determining incidence rates of mTBI remains challenging given a significant proportion of individuals do not present to a hospital following injury (Thomas, Fitzgerald, & Cowen, 2020). In the acute stage of mTBI, cognitive deficits are one of the key symptoms of injury.…”

Section: Introductionmentioning

confidence: 99%

Decreased working memory capacity in the chronic phase of mild traumatic brain injury

Fox,

Filmer,

Dux

2024

Preprint

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Despite increasing recognition of the significance of mild traumatic brain injury (mTBI), our knowledge of the long-term cognitive impacts of the injury remains incomplete. Currently, the chronic mTBI literature conveys conflicting findings, likely in large part due to the use of measures that lack sensitivity to detect subtle cognitive changes and failures to consider individual differences in cognitive outcomes post mTBI. In addition, while it is well documented that a significant number of injuries go unreported, studies investigating individuals with a history of mTBI that capture these unreported injuries are lacking in comparison to those using hospital-based samples. In this preregistered study, we used a range of complex behavioural tasks to investigate cognitive performance in a large sample of individuals with self-reported history of mTBI (n=82) and a control group (n=88). We also explored whether individual differences in injury-related factors predict cognitive performance in the mTBI group. The findings revealed poorer verbal working memory performance in mTBI participants compared to controls. No group differences were observed on tasks assessing visual working memory, multitasking ability, cognitive flexibility, attentional control, visuospatial ability, or information processing speed. Furthermore, the individual differences analyses suggest that age at injury may be an important predictor of working memory performance in both verbal and visual domains following mTBI. Together, these findings indicate that mTBI may have lasting impacts on verbal working memory capacity and that injury-related factors, such as age when the injury occurred, may be crucial to consider when assessing cognitive outcome in individuals with a history of mTBI.

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Section: Introductionmentioning

confidence: 99%

Decreased working memory capacity in the chronic phase of mild traumatic brain injury

Fox,

Filmer,

Dux

2024

Preprint

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“…Internationally, the economic impact (including hospitalization and productivity-related costs) of concussion is profound 9,11,12 . As people who experience a concussion may not seek medical attention, 13 understanding the impact concussion has on societies is currently limited.…”

Section: Introductionmentioning

confidence: 99%

“…Further, the authors stated acute health services should expect a percentage of patients being discharged will experience PPCS and functional difficulties. Such findings suggest a significant health burden that is not yet fully understood 11 . This dilemma poses a potentially significant care and cost liability for health care systems globally; emphasizing a pressing need to build the evidence base to support effective health care (including allied health services) that may influence patient outcomes, health care service utilization, and associated costs.…”

Section: Introductionmentioning

confidence: 99%

“…Internationally, the economic impact (including hospitalization and productivity-related costs) of concussion is profound. 9 , 11 , 12 As people who experience a concussion may not seek medical attention, 13 understanding the impact concussion has on societies is currently limited. Further, for people who seek medical attention, evidence suggests they may experience barriers to accessing the specialist and evidence-based care required post-concussion.…”

Section: Introductionmentioning

confidence: 99%

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Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol

Licciardi,

Olver,

Lalor

et al. 2023

JBI Evidence Synthesis

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Objective: The objective of the review is to identify, categorize, and examine literature describing occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms (PPCS). Introduction: PPCS are symptoms experienced by adults a minimum of 2 to 4 weeks after a traumatic brain injury (TBI), and include vestibular, neuropsychiatric, visual, and cognitive issues. Enduring PPCS may result in disability, affecting a person’s independence and/or participation in daily activities. Despite growing recognition of the role occupational therapy can offer in TBI rehabilitation, evidence is limited regarding the scope of practice occupational therapists have in the rehabilitation of adults experiencing PPCS. Inclusion criteria: Literature that includes adults (aged 18 to 65 years) experiencing PPCS that describes the occupational therapy scope of practice in concussion programs will be considered for inclusion in this review. Sources reporting on participants aged under 18 years; classified with non-persistent symptoms; receiving care in acute health care settings; non-English publications; or gray literature from civil society or disabled persons organizations or other representative bodies in the field of brain injury will be excluded. Methods: The scoping review will follow the JBI methodology for scoping reviews. Five electronic databases will be searched for literature between 2013 and the present: MEDLINE, Embase, Emcare, PsycINFO, and CINAHL. Two reviewers will independently conduct title and abstract screening of the results and, upon consensus, independently screen full texts to confirm final sources for inclusion. Any disagreements will be resolved by discussion with a third reviewer. Data extraction from included sources will map occupational therapy scope of practice (inclusive of assessments and interventions) against the World Health Organization’s International Classification of Functioning One-Level Classification and be presented in tabular or narrative format. Review Registration: Open Science Framework osf.io/qxgzj

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“…]. There is limited literature on the incidence of concussion in Australia, although some have estimated that 170,000 concussions are sustained annually in Australia [ 108. ].…”

Section: Introductionmentioning

confidence: 99%

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms

Nguyen

McKay

Ponsford

et al. 2022

Pilot Feasibility Stud

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Background Up to 25% of concussed individuals experience persistent post-concussion symptoms (PPCSs) which may interfere with the return to pre-injury activities and cause significant stress. Given that multiple etiological factors are thought to contribute to PPCSs, an interdisciplinary approach is recommended. This pilot study aims to primarily investigate the feasibility of a novel interdisciplinary treatment for PPCSs. Given this intervention is novel, uncertainty exists in terms of potential recruitment and retention rates, adverse events, and treatment adherence and fidelity. These factors will be explored to inform the feasibility of a phase-2 randomised controlled trial. Preliminary efficacy of this intervention will also be explored. Methods Fifteen individuals with mild traumatic brain injury and PPCSs will receive up to 12 weeks of interdisciplinary treatments including psychology, physiotherapy, and medical interventions. Primary feasibility outcomes including data on recruitment and retention rates and treatment adherence will be explored descriptively. The cognitive therapy rating scale will be used to assess treatment fidelity. A single-case series with multiple baseline design will be used to explore preliminary efficacy. Participants will be randomly assigned to baseline phases of 2, 4, or 6 weeks. Regarding patient-centred secondary outcomes, the Rivermead Post-Concussion Symptoms Questionnaire will be assessed three times a week during baseline and treatment phases. Secondary outcomes also include measures of mood, sleep and fatigue, physical functioning, return to activity, and health-related quality of life. Patient-centred outcomes will be assessed at baseline, pretreatment, post-treatment, and one- and three-month follow-up. Thematic analysis of participant experiences will be explored through qualitative interviews. Discussion Results from this trial will inform the feasibility and preliminary efficacy of this interdisciplinary concussion intervention and whether proceeding to a future definitive phase-2 randomised controlled trial is worthwhile. Understanding the end-user perspective of the treatment will also enable modifications to the treatment protocol for future trials to best suit the needs of individuals with PPCSs after mTBI. Outcomes from this trial can be directly translated into community rehabilitation programmes. Trial registration ANZCTR, ACTRN12620001111965. Registered 27 October 2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379118

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Does Australia have a concussion ‘epidemic’?

Cited by 9 publications

References 6 publications

Decreased working memory capacity in the chronic phase of mild traumatic brain injury

Decreased working memory capacity in the chronic phase of mild traumatic brain injury

Occupational therapy scope of practice in the rehabilitation of adults experiencing persistent post-concussion symptoms following traumatic brain injury: a scoping review protocol

Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms

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