Occupational and Physiotherapy modalities used to support interdisciplinary rehabilitation after concussion: A Scoping Review

Abstract

Objective: To identify and describe occupational and physiotherapy rehabilitation modalities used to support an interdisciplinary rehabilitation in adults (aged 16 + years) with concussion.Methods: A scoping review methodology was used. Included studies were categorized according to Wade’s elements of rehabilitation and the Danish White Paper definition of rehabilitation.Results: Ten studies were included in this review, addressing: “assessment” (n = 9), “goal-setting” (n = 4), “training” (n = 10), and “social participation and discharge support” (n = 4). Interventions were delivered mainly by physiotherapists or an interdisciplinary team. In two studies occupational therapists were part of the interdisciplinary team. Randomized controlled trials more often addressed several of the rehabilitation elements using interdisciplinary intervention delivery. No studies specifically aimed their intervention at patients with acute or subacute concussion.Conclusion: The therapeutic modalities identified were: (i) manual and sensory motor interventions; (ii) physical exercises; and (iii) management of, or coping with, symptoms. More research is needed on how to better support social participation and discharge or return to work in the rehabilitation process. In addition, interventions delivered in the acute phases of concussion need further exploration.LAY ABSTRACTIndividuals with prolonged or persisting symptoms from a concussion often struggle to participate in activities of daily living, and their quality of life and work ability is affected. Interdisciplinary rehabilitation is recommended, and it is recognized that occupational and physiotherapy is important to support the interdisciplinary rehabilitation and promote recovery. However, this scoping review found that occupational therapists were seldom part of the interdisciplinary rehabilitation team. Furthermore, the physiotherapy and occupational rehabilitation modalities used consisted of manual or sensory motor interventions, physical exercise interventions, and management and coping. Only a few studies included social participation and discharge support as a part of the rehabilitation. No studies specifically aimed their intervention at preventing prolonged symptoms in patients with acute or subacute concussion. There is a need for more research into how to better support social participation and discharge in the rehabilitation process. Also, interventions delivered in the acute phases of concussion need further exploration.

Maximizing the Clinical Value of Blood-Based Biomarkers for Mild Traumatic Brain Injury

“…In addition, the lack of effective treatment for mild TBI beyond rehabilitation and symptomatic relief makes the idea of applying the Alinity i TBI test data to acquire a more complete understanding of damage development very appealing [117,118]. This type of understanding is necessary if a breakthrough is to come, whether through the repurposing of current drugs or the application of new gene-expression-altering technologies to interrupt a program of neuronal destruction set in motion by the head injury [119].…”