4.1 Article

Rehabilitation of Concussion and Persistent Postconcussive Symptoms

Journal

SEMINARS IN NEUROLOGY
Volume 41, Issue 2, Pages 124-131

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0041-1725134

Keywords

concussion; persistent post concussion symptoms; post-concussion syndrome; cervicogenic headache; active rehabilitation

Funding

  1. National Institute of Neurological Disorders and Stroke of the National Institutes of Health (NIH) [1R01NS094444]
  2. National Center for Advancing Translational Sciences of the NIH [UL1TR001412]

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Concussion and PPCS are common clinical issues in multiple medical fields, requiring multidisciplinary management. Outpatient diagnosis involves a structured approach combining history, physical examination, and additional tests, with individualized treatment options based on predominant signs and symptoms.
Concussion and persistent postconcussive symptoms (PPCS) are encountered by clinicians in sports medicine, pediatrics, neurology, physiatry, emergency medicine, and primary care. Clinical management may require a multidisciplinary approach. This article presents a structured method for the diagnosis of concussion and PPCS in the outpatient setting, which includes a history, physical examination, and additional tests as clinically indicated to help identify underlying symptom generators. Treatment for concussion and PPCS should be individualized, based on predominant signs and symptoms, and can include subsymptom threshold aerobic exercise, cervical physical therapy, vestibulo-ocular rehabilitation, behavioral and cognitive psychotherapy, and some symptom-specific pharmacological therapies.

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