Efficiency of an Active Rehabilitation Intervention in a Slow-to-Recover Paediatric Population following Mild Traumatic Brain Injury: A Pilot Study

Abstract

Objective. The aim of this study was to identify whether the addition of an individualised Active Rehabilitation Intervention to standard care influences recovery of young patients who are slow-to-recover following a mTBI. Methods. Fifteen participants aged 15 ± 2 years received standard care and an individualised Active Rehabilitation Intervention which included (1) low- to high-intensity aerobic training; (2) sport-specific coordination exercises; and (3) therapeutic balance exercises. The following criteria were used to measure the resolution of signs and symptoms of mTBI: (1) absence of postconcussion symptoms for more than 7 consecutive days; (2) cognitive function corresponding to normative data; and (3) absence of deficits in coordination and balance. Results. The Active Rehabilitation Intervention lasted 49 ± 17 days. The duration of the intervention was correlated with self-reported participation (truex-=84.64±19.63%, r = −0.792, p < 0.001). The average postconcussion symptom inventory (PCSI) score went from a total of 36.85 ± 23.21 points to 4.31 ± 5.04 points after the intervention (Z = −3.18, p = 0.001). Conclusion. A progressive submaximal Active Rehabilitation Intervention may represent an important asset in the recovery of young patients who are slow-to-recover following a mTBI.

An innovative approach to measuring youth concussion recovery: Occupational performance

“…Active rehabilitation interventions commonly consist of aerobic exercise, alongside coordination drills, visualization, and education. Several studies on active rehabilitation interventions for youth with persistent symptoms have found improvement in symptoms following intervention (see for example Dobney et al, 2017;Gagnon et al, 2009Gagnon et al, , 2015Imhoff et al, 2016;Kurowski et al, 2017;Lawrence et al, 2018).…”

Concussion Practice Patterns among Speech-Language Pathologists

“…A review of guidelines for concussion care emphasizes the effectiveness of patient/family education specifically to validate symptoms, outline the expected trajectory of recovery, and help establish realistic goals [1] [26] [27] [28] [29]. Guidelines for concussion care also highlight symptom management and the importance of establishing techniques to stay within a subthreshold level so as not to exacerbate the symptoms [30] [31].…”

“…[20] [26] [27] [28] [29] [30] [41]. The more understanding patients have regarding their symptoms, the less likely they are to overreact to them or attribute them to significant brain damage[6] [42] [43].…”

“…[8] [29] [41]. The SLP can facilitate that plan and disseminate information to the educator concomitant with providing cognitive-communication therapy.While assisting with a return to work plan, the SLP can determine strategies to optimize cognitive-communication performance by modifying the environment to optimize function, limiting distractions, approaching one task at a time, manipulating pacing, and using techniques to support processing and memory[34] [41].…”

Engagement in daily life physical activity reduces self-reported symptoms in adolescent concussion

“…Specifically, adolescents who engaged in a rehabilitation program involving physical activity within the first month after concussion experienced reduced symptoms (Chrisman et al, 2017;Grool et al, 2016). Additionally, rehabilitation programs that included structured aerobic physical activity for adolescents with persistent symptoms beyond one-month reduced persistent symptoms (Gagnon, Galli, Friedman, Grilli, & Iverson, 2009;Gagnon, Grilli, Friedman, & Iverson, 2016;Imhoff, Fait, Carrier-Toutant, & Boulard, 2016;Kurowski et al, 2017).…”