Concussion and Mild Traumatic Brain Injury (mTBI)
Concussions and other forms of mild traumatic brain injuries, especially those resulting from traditional contact sports have been the subject of increasingly intense attention from many parent, media, and medical groups; and for good reason. Research from leading experts in the field of traumatic brain injury consistently produce evidence of the alarming, and even potentially life threatening, long-term results of chronic or repeated mild injury to the brain or head.
Brain Hub in Sydney focuses on progressive vestibular rehabilitation and brain-based therapy (supporting medical and clinical neuroscience research on the management of these conditions with vestibular rehabilitation is provided within the website) for people suffering from:
- Dizziness and balance disorders
- BPPV (benign paroxysmal positional vertigo)
- mTBI (mild traumatic brain injury)
- ABI (acquired brain injury)
Concussion and Mild Traumatic Brain Injury (mTBI)
Concussions are the most common form of mild traumatic brain injury. Often the result of being struck or bumped or in the head, concussions cause a temporary disruption in brain function that may or may not result in immediate physical or mental symptoms.
While most people commonly associate a concussion with being “knocked out”; nothing could be further from the truth. In fact, research indicates that nearly 90% of concussions occur without the loss of conscious.
Common Causes of Concussion and mTBI
Mild traumatic brain injuries can occur anytime something causes the brain to jolt against the skull. The CDC estimates one concussion occurs every 21 seconds1 . The most common causes of mild traumatic brain injury and concussion include:
- Car Accidents
- Horseback Riding Injuries
- Falls (most occurring in the elderly)
- Playground Injuries
- Sports-Related Injuries (especially in rugby, American football, hockey, cycling, MMA, boxing, skiing and snowboarding).
Concussion and mTBI Statistics
Of particular concern is the fact that in Australia alone, sports-related concussions occurring in children have increased by over 60% in the last 10 years 4. Adding to the concern with sports-related mTBI is the fact that athletes suffering a concussion are 40% to 60% more likely to suffer a second concussion. Research clearly demonstrates that young athletes suffering concussions are early concussions are at a significantly increased risk to suffer debilitating physical and mental decline up 3 decades later.
Basic Concussion Neuroscience
Concussions are caused by a sudden blow to the head that leads to a temporary disruption in brain activity. Symptoms in the minutes and hours following a concussion can range from a temporary loss of consciousness and general disorientation to dizziness, nausea, and vomiting. With rest, these symptoms generally subside within several days. But for some, persistent headaches sleep disturbances, memory problems, and difficulties concentrating will continue for weeks or longer.
Concussions and mTBI occur when the brain is slammed against the skull with enough force to stretch, tear, or damage the cells of the brain.
Once injured, electrical and chemical function of the brain cell is impeded; to compensate for the injury, the brain focuses on repairing the injury, shutting down the injured-portion of the brain as it heals.
While most of the damage caused during a first-time concussion is temporary, some result in permanent damage; repeated concussions, and especially those occurring before the brain has completely healed can result in long-term changes in the brain resulting in a degenerative disease known as chronic traumatic encephalopathy (CTE).
Preseason Baseline Concussion Testing
We highly recommend that all competitive athletes, regardless of age, undergo a preseason baseline concussion test prior to participating in practices or competition.
Our Preseason Baseline Concussion Testing program is completed in under 30 minutes and assesses athletes’ pre-concussion cognitive performance in a number of important areas, including:
- Eye-Movement Recordings
- Reaction Time
- Problem Solving
- Short and Long-Term Memory
- Potential Pre-Existing Concussion Symptoms
Our preseason data is then used to compare athletes’ performance on the test after a concussion has occurred. Our highly trained medical staff uses this data to develop a personalized “return to play” recovery plan for each of our athletes. Click here to learn more about Preseason Baseline Concussion Testing
Symptoms of Concussions
While a bump on the head may not seem that big of a deal to the young athlete, the long-term effects of a concussion, especially multiple concussions, can be dire and have been observed to mimic the symptoms of Parkinson’s and Alzheimer’s disease.
According to the Mayo Clinic, complications of concussion may include5 :
- Epilepsy the chance of developing epilepsy is double during the first 5 years following a concussion.
- Post-concussion syndrome often occurring days after the initial concussion, symptoms included headache, dizziness and balance issues, and cognitive processing issues, post-concussion syndrome has been observed to last weeks and even a few months after initial concussion, post-traumatic headaches.
- Post-traumatic vertigo mild traumatic brain injuries can cause a constant feeling of dizziness, spinning and loss of balance that lasts days, a few weeks, or even several months.
Chronic Traumatic Encephalopathy (CTE)
Perhaps the most significant condition associated with concussion and mild traumatic brain injury is a condition known as chronic traumatic encephalopathy (CTE). This progressive, irreversible result of chronic, recurrent brain injuries – including concussions – is often a result of brain injuries, including concussions, with symptoms showing a few years to decades after participation in sports.
CTE is a condition where the brain deteriorates as a result of an excess build up of the protein tau. Progressive over time, CTE results in debilitating mental and physical conditions, including confusion, impaired judgment and impulse control, aggression, depression, anxiety, suicidal thoughts, and eventually results in progressive dementia 6.
- Sufrinko AM, Mucha A, Covassin T, Marchetti G, Elbin RJ, Collins MW, Kontos. Sex Differences in Vestibular/Ocular and Neurocognitive Outcomes After. Sport-Related Concussion. Clin J Sport Med. 2016 Jul 1.
- Vargo MM, Vargo KG, Gunzler D, Fox KW. Interdisciplinary Rehabilitation Referrals in a Concussion Clinic Cohort: An Exploratory Analysis. PM R. 2016 Mar;8(3):241-8
- Alsalaheen BA, Whitney SL, Marchetti GF, Furman JM, Kontos AP, Collins MW, Sparto PJ. Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion. Cain J Sport Med. 2016 Jan;26(1):46-52.
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- Kelley AM, Ranes BM, Estrada A, Grandizio CM. Evaluation of the Military Functional Assessment Program: Preliminary Assessment of the Construct Validity Using an Archived Database of Clinical Data. J Head Trauma Rehabil. 2015 Jul-Aug;30(4):E11-20.
- Broglio SP, Collins MW, Williams RM, Mucha A, Kontos AP. Current and emerging rehabilitation for concussion: a review of the evidence. Clin Sports Med. 2015 Apr;34(2):213-31.
- DePalma RG. Combat TBI: History, Epidemiology, and Injury Modes(). In: Kobeissy FH, editor. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects. Boca Raton (FL): CRC Press/Taylor & Francis; 2015. Chapter 2.
- Conder R, Conder AA. Neuropsychological and psychological rehabilitation interventions in refractory sport-related post-concussive syndrome. Brain Inj. 2015;29(2):249-62.
- Valovich McLeod TC, Hale TD. Vestibular and balance issues following sport-related concussion. Brain Inj. 2015;29(2):175-84.
- Carrick FR, McLellan K, Brock JB, Randall C, Oggero E. Evaluation of the Effectiveness of a Novel Brain and Vestibular Rehabilitation Treatment Modality in PTSD Patients Who have Suffered Combat-Related Traumatic Brain Injuries. Front Public Health. 2015 Feb 4;3:15.
- McCulloch KL, Goldman S, Lowe L, Radomski MV, Reynolds J, Shapiro R, West TA. Development of clinical recommendations for progressive return to activity after military mild traumatic brain injury: guidance for rehabilitation providers. J Head Trauma Rehabil. 2015 Jan-Feb;30(1):56-67.
- Franke LM, Czarnota JN, Ketchum JM, Walker WC. Factor analysis of persistent postconcussive symptoms within a military sample with blast exposure. J Head Trauma Rehabil. 2015 Jan-Feb;30(1):E34-46.
- Vanderploeg RD, Silva MA, Soble JR, Curtiss G, Belanger HG, Donnell AJ, Scott. The structure of postconcussion symptoms on the Neurobehavioral Symptom Inventory: a comparison of alternative models. J Head Trauma Rehabil. 2015 Jan-Feb;30(1):1-11.
- Ingriselli JM, Register-Mihalik JK, Schmidt JD, Mihalik JP, Goerger BM, Guskiewicz KM. Outcomes, utility, and feasibility of single task and dual task intervention programs: preliminary implications for post-concussion rehabilitation. J Sci Med Sport. 2014 Nov;17(6):580-5.
- Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014 Oct;42(10):2479-86.
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- Bigsby K, Mangine RE, Clark JF, Rauch JT, Bixenmann B, Susaret AW, Hasselfeld KA, Colosimo AJ. Effects of postural control manipulation on visuomotor training performance: comparative data in healthy athletes. Int J Sports Phys Ther. 2014 Aug;9(4):436-46.
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- Powers KC, Kalmar JM, Cinelli ME. Recovery of static stability following a concussion. Gait Posture. 2014;39(1):611-4.
- Alsalaheen BA, Whitney SL, Mucha A, Morris LO, Furman JM, Sparto PJ. Exercise prescription patterns in patients treated with vestibular rehabilitation after concussion. Physiother Res Int. 2013 Jun;18(2):100-8
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- Alsalaheen BA, Mucha A, Morris LO, Whitney SL, Furman JM, Camiolo-Reddy CE, Collins MW, Lovell MR, Sparto PJ. Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther. 2010 Jun;34(2):87-93.
- Gottshall K, Gray N, Drake AI. A unique collaboration of female medical providers within the United States Armed Forces: rehabilitation of a marine with post-concussive vestibulopathy. Work. 2005;24(4):381-6
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Solution for Concussion & mTBI
Reference (medical and clinical neuroscience research) SUPPORTING the use of VESTIBULAR REHABILITATION for the management of CONCUSSIONS is included above
- Physical examination
- Neurological testing
- Metabolic and nutritional
- History questionnaires
- Report of findings
- Clear answers
- Options for treatment
- Solution recommended
- Physical therapy and exercises
- Neurological and brain-based therapy
- Vestibular (balance) rehabilitation
- Metabolic and dietary