Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the effica...Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.展开更多
In this clinical practice review, the controversies and difficulties managing post concussion symptoms following mild traumatic brain injury are discussed. Based on considerable clinical experience in a designated Con...In this clinical practice review, the controversies and difficulties managing post concussion symptoms following mild traumatic brain injury are discussed. Based on considerable clinical experience in a designated Concussion Clinic, the authors (a neuropsychologist, a psychiatrist, and a neurologist) review relevant literature and issues for clinical practice, particularly with respect to understanding risk factors for and vulnerability to, development of chronic post-concussion symptoms. We contend it is not just the kind of head that matters but also the kind of complications, the kind of outcomes and the kind of management that can influence injury recovery. Given these complexities, a bio-psychosocial conceptualization of chronic post-concussion syndrome is appropriate. Though understanding is still elusive, management should not be biased by physiogenic or psychogenic aetiological theories for management needs to address patient reported outcomes regardless of underpinning aetiology.展开更多
A 60-year-old female with post-concussion syndrome (PCS) presented with persistent cognitive deficits and functional limitations following a slip and fall. She underwent a multimodal therapeutic protocol including hyp...A 60-year-old female with post-concussion syndrome (PCS) presented with persistent cognitive deficits and functional limitations following a slip and fall. She underwent a multimodal therapeutic protocol including hyperbaric therapy (HBT), photobiomodulation (PBM), and molecular hydrogen (MH) therapy over 10 sessions. Pre- and post-treatment assessments demonstrated significant improvements in cognitive function and neurophysiological markers, as evidenced by WAVi EEG and Trail Making Test (TMT) results. This case highlights the potential of a non-invasive, multimodal therapeutic approach to address persistent post-concussion symptoms, an area with limited effective interventions. Findings suggest that integrating these therapies into standard rehabilitation protocols may enhance recovery trajectories, particularly for patients with persistent cognitive symptoms. This case report explores the clinical course, treatment efficacy, and the potential for combining these therapies in addressing complex neurological recovery.展开更多
This case report examines the impact of mild hyperbaric oxygen therapy (mHBOT) on cognitive function and symptom relief in a 35-year-old male presenting with concussive symptoms (CS) following a motor vehicle accident...This case report examines the impact of mild hyperbaric oxygen therapy (mHBOT) on cognitive function and symptom relief in a 35-year-old male presenting with concussive symptoms (CS) following a motor vehicle accident (MVA). The patient underwent 10 mHBOT sessions over five weeks (40 minutes per session at 1.5 ATA with 32% oxygen). Post-treatment assessments revealed significant improvements, including an increase in P300 voltage from 4.2 µV to 9.2 µV, aligning with the normative range of 8 - 21 µV. Electroencephalogram (EEG) analysis demonstrated enhanced alpha and theta band activity, reflecting improved cognitive processing and attentional regulation. Clinically, the patient reported reduced headache severity, improved sleep quality, and decreased pain intensity. These findings suggest that mHBOT may support neuroplasticity, mitigate inflammation, and restore cognitive function in patients with CS. Further research, including randomized controlled trials (RCTs), is warranted to validate mHBOT’s efficacy and explore its long-term benefits in traumatic brain injury (TBI) rehabilitation.展开更多
Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, pote...Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trauma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of validity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.展开更多
OBJECTIVE: To identify current SLP practice patterns in concussion care, clarify definitions of common cognitive retraining terminology, and establish areas of growth in clinical practice and research. METHOD: An onli...OBJECTIVE: To identify current SLP practice patterns in concussion care, clarify definitions of common cognitive retraining terminology, and establish areas of growth in clinical practice and research. METHOD: An online 10 question survey to collect data on assessment and practice components. Total 79 respondents from ASHA Special Interest Group 2 Neurogenic Communication Disorders website participated. Data were analyzed using descriptive statistics. RESULTS: Patient education and symptom management were regular components of cognitive retraining with concussion. Smaller percentage included cognitive endurance building. Further analysis identified variation in how clinicians defined terms: patient education, symptom management, and cognitive endurance building. Discrepancies noted with diagnostic tools, with one quarter using screening tools as primary assessment. CONCLUSION: Strong knowledge base to support differential diagnosis and therapeutic plan is critical to optimize outcomes in concussion care. Consistency with terminology use can reduce the risk of confusion but also support the value of what SLPs contribute to an interdisciplinary concussion team.展开更多
文摘Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.
文摘In this clinical practice review, the controversies and difficulties managing post concussion symptoms following mild traumatic brain injury are discussed. Based on considerable clinical experience in a designated Concussion Clinic, the authors (a neuropsychologist, a psychiatrist, and a neurologist) review relevant literature and issues for clinical practice, particularly with respect to understanding risk factors for and vulnerability to, development of chronic post-concussion symptoms. We contend it is not just the kind of head that matters but also the kind of complications, the kind of outcomes and the kind of management that can influence injury recovery. Given these complexities, a bio-psychosocial conceptualization of chronic post-concussion syndrome is appropriate. Though understanding is still elusive, management should not be biased by physiogenic or psychogenic aetiological theories for management needs to address patient reported outcomes regardless of underpinning aetiology.
文摘A 60-year-old female with post-concussion syndrome (PCS) presented with persistent cognitive deficits and functional limitations following a slip and fall. She underwent a multimodal therapeutic protocol including hyperbaric therapy (HBT), photobiomodulation (PBM), and molecular hydrogen (MH) therapy over 10 sessions. Pre- and post-treatment assessments demonstrated significant improvements in cognitive function and neurophysiological markers, as evidenced by WAVi EEG and Trail Making Test (TMT) results. This case highlights the potential of a non-invasive, multimodal therapeutic approach to address persistent post-concussion symptoms, an area with limited effective interventions. Findings suggest that integrating these therapies into standard rehabilitation protocols may enhance recovery trajectories, particularly for patients with persistent cognitive symptoms. This case report explores the clinical course, treatment efficacy, and the potential for combining these therapies in addressing complex neurological recovery.
文摘This case report examines the impact of mild hyperbaric oxygen therapy (mHBOT) on cognitive function and symptom relief in a 35-year-old male presenting with concussive symptoms (CS) following a motor vehicle accident (MVA). The patient underwent 10 mHBOT sessions over five weeks (40 minutes per session at 1.5 ATA with 32% oxygen). Post-treatment assessments revealed significant improvements, including an increase in P300 voltage from 4.2 µV to 9.2 µV, aligning with the normative range of 8 - 21 µV. Electroencephalogram (EEG) analysis demonstrated enhanced alpha and theta band activity, reflecting improved cognitive processing and attentional regulation. Clinically, the patient reported reduced headache severity, improved sleep quality, and decreased pain intensity. These findings suggest that mHBOT may support neuroplasticity, mitigate inflammation, and restore cognitive function in patients with CS. Further research, including randomized controlled trials (RCTs), is warranted to validate mHBOT’s efficacy and explore its long-term benefits in traumatic brain injury (TBI) rehabilitation.
基金Department of Physical Medicine&Rehabilitation funding by the United States Department of Education,National Institute of Disability Research and Rehabilitation#H133A120099(TBI Model Systems grant)
文摘Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trauma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of validity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.
文摘OBJECTIVE: To identify current SLP practice patterns in concussion care, clarify definitions of common cognitive retraining terminology, and establish areas of growth in clinical practice and research. METHOD: An online 10 question survey to collect data on assessment and practice components. Total 79 respondents from ASHA Special Interest Group 2 Neurogenic Communication Disorders website participated. Data were analyzed using descriptive statistics. RESULTS: Patient education and symptom management were regular components of cognitive retraining with concussion. Smaller percentage included cognitive endurance building. Further analysis identified variation in how clinicians defined terms: patient education, symptom management, and cognitive endurance building. Discrepancies noted with diagnostic tools, with one quarter using screening tools as primary assessment. CONCLUSION: Strong knowledge base to support differential diagnosis and therapeutic plan is critical to optimize outcomes in concussion care. Consistency with terminology use can reduce the risk of confusion but also support the value of what SLPs contribute to an interdisciplinary concussion team.
