Is it indicated in all age groups?
Until recently, best practices for concussion management were largely generalized across age groups. It is crucial that we have guidelines to follow that are representative of the developmental stages across children, adolescents, and adults. One of the specific recommendations through both a review of the scientific literature, as well as from Rowan’s law, is the use of Neurocognitive Testing at baseline in youth sports is not warranted, regardless of the level of play. While there continues to be advancements both in the development and use of neurocognitive testing, the research has been unable to provide documentation for the stability of test values over prolonged periods (i.e. duration of one sport season) in children. Because the paediatric brain is developing so rapidly, neurocognitive measures are changing in a way that does not allow for the reliability that the research has shown in older adults and high school athletes. This has shown to be true across many methods of testing typically used in baseline evaluations.
Eliminating the use of baseline testing in youth does not minimize the continued need for the proper education of coaching and training staff. It is recommended that the resources typically used for baseline testing are instead allocated towards improving the training available on recognition and acute management strategies when there is a suspected injury. We know that concussive injuries can have many different presentations, with both immediate and delayed onset, sometimes with subtle signs and symptoms. The coaching staff are typically the first line of contact in youth sport once an injury has been sustained, and it is extremely important that they are prepared and educated to take the appropriate action, preventing premature return to play.
StopConcussions and Shift Concussion Management provide an advanced approach to concussion awareness and management. Formed in partnership by Stopconcussions.com, an organization founded by former Philadelphia Flyers captain, Keith Primeau, and the Shift Concussion Management Program, Shift Concussion Management is a one of the leaders in Concussion Care.
How it Works
In our older athletes, baseline or pre-season evaluation may lend value to the concussion management process when implemented as part of a comprehensive concussion strategy. Baseline testing may involve a combination of tests including neurocognitive evaluation, assessment of balance, visuomotor skills and other measures of coordination and physical functioning. It is important to seek testing by Healthcare Professionals experienced with concussion rehabilitation such as Shift Concussion Management.
After an Injury
It’s recommended that following a concussion that you schedule an appointment with your Physician to ensure there are not any underlying issues from your injury (such as brain bleed, fractures, etc.). Although standard imaging studies such as X-rays, CTs, and MRIs do not typically show any abnormalities following a concussion, the physician may order these tests to rule out other trauma to the skull or neck.
Following their assessments, it’s recommended to book an appointment with a facility that primarily deals with concussion cases, such as Shift Concussion Management. During your concussion assessment you will be asked to describe the symptoms you’ve experienced, and you may undergo several tests to determine if a concussion is suspected.
These tests may include a variety of the following:
- Visual exam
- Balance assessment (with your eyes open, and then closed)
- Coordination testing
Gait evaluation (observing you walk, watching you walk heel-to-toe)
- Checking your neck for pain, tenderness or limited motion
Please note: The previous list is not exhaustive nor does having one or more of these symptoms mean that someone has a concussion. It is merely a guide to possible concussive symptoms. It is important to seek medical attention immediately to receive a diagnosis.
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Unfortunately, there is no “gold standard” for the diagnosis of concussion. No single test exists to determine defnitively that a concussion has occurred. Your Practitioner has to integrate the results from the various tests to establish the overall picture. If there is a typical mechanism of injury consistent with concussion and the athlete reports any one or more of the known symptoms, a concussion diagnosis is given. However, not all medical doctors and health professionals are up to date on diagnosis and the current management strategies. We would always recommend seeking out care from Practitioners who predominantly see concussion cases in their practice. If you think your doctor’s visit was not informative or thorough, seek a second opinion.
In the event that you or your child requires more specialized assessment, you may be referred to a medical specialist such as a sport physician, neurologist, pediatrician or neuropsychologist who has expertise in concussion and brain injury management. This measure is not always required initially and may be reserved for situations of prolonged recovery or severe impairment.
We would always recommend seeking out care from Practitioners who predominantly see concussion cases in their practice like Shift Concussion Management. If you think your doctors visit was not informative or thorough, seek a second opinion.