Post-Concussion Management Program

 

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At Therapeutic Rehab Specialists we offer a unique way of treating and managing post concussive symptoms.

  • Evaluating and improving diaphragmatic breathing as there is a significant relationship between breathing patterns and movement dysfunction. Breathing impacts movement!
  • Cranial cryotherapy which helps bring down inflammation post TBI
  • Treatment with NuCalm for improving heart rate variability (HRV) decreasing stress, cortisol levels, anxiety and promoting restful sleep and recovery
  • Vestibular rehab and balance training
  • Manual therapy techniques such as soft tissue mobilization, trigger point release therapy and highly skilled and detailed joint mobilization as there is often upper cervical spine dysfunction found in post-concussive individuals
  • Nutritional counseling on improving post TBI nutrition and promoting optimal healing based on the latest research
  • Cutting edge therapies are used such as TouchPoints: neuroscientific wearables producing haptic microvibrations called BLAST (bilateral alternating stimulation tactile), that are worn on either side of the body. Using gentle vibration affects the brain and alters the body’s fight/flight response to restore and calm nervous system functioning. Pulsating red light therapy is also used to promote relaxation and stimulate natural melatonin production.
  • Professionally monitored graded exercise programs based on physiological response to exercise through heart rate monitoring and heart rate variability testing.

Concussion is a disturbance in brain function caused by direct or indirect force to the head. It is a functional rather than structural injury that results from shear stress to brain tissue caused by rotational or angular forces—direct impact to the head is not required. Initial evaluation involves eliminating cervical spine injury and serious traumatic brain injury. Headache is the most common symptom of concussion, although a variety of clinical domains (e.g., somatic, cognitive, affective) can be affected. Signs and symptoms are nonspecific; therefore, a temporal relationship between an appropriate mechanism of injury and symptoms must be determined.

Numerous assessment tools should be used to monitor recovery. Cognitive and physical rest are the cornerstones of initial management. The focus of treatments for concussion should be based on managing symptoms and a monitored and gradual return to play.

Definition of Traumatic Brain Injury

A traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force that is indicated by new onset or worsening of at least one of the following clinical signs, immediately following the event:

  • Any period of loss of or a decreased level of consciousness (LOC)
  • Any loss of memory for events immediately before or after the injury (post-traumatic amnesia [PTA])
  • Any alteration in mental state at the time of the injury (confusion, disorientation, slowed thinking, etc.) (Alteration of consciousness/mental state [AOC])
  • Neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia, sensory loss, aphasia, etc.) that may or may not be transient
  • An Intracranial lesion.

Most Frequent Symptoms of Concussion

  • Affective/emotional
    • Anxiety/nervousness
    • Depression
    • Personality changes
    • Sadness
  • Cognitive
    • Amnesia
    • Lethargy
    • Feeling stunned
    • Inability to focus
    • Loss of consciousness
    • Slurred speech
    • Vacant stare
    • Unstable Emotions
    • Disorientation (before, during, or after injury)
  • Sleep
    • Decreased sleep
    • Increased sleep
    • Difficulty initiating sleep
    • Drowsiness
  • Somatic/physical
    • Blurred vision
    • Convulsions Dizziness/poor balance
    • Fatigue
    • Headache
    • Light-headedness
    • Light sensitivity
    • Noise sensitivity
    • Nausea
    • Numbness/tingling
    • Vomiting
    • Tinnitus
    • Changes in balance, coordination or reaction time

7 keys to optimizing recovery following a concussion or traumatic brain injury

1) Progressive and gradual return to exercise at least 4 times a week.

Exercise, particularly strength training, stimulates the production of nerve growth factors that encourage stem cell activity and help build more synapses between brain cells.

2) Eliminate sugar and artificial sweeteners.

Sugar increases insulin levels in the brain. Higher insulin levels are associated with more rapid loss of synapses and accelerated atrophy of the brain and spinal cord. Artificial sweeteners are excitotoxins, which induce excessive production of glutamate in the brain, again leading to accelerated atrophy.

3) Replace grain based and gluten filled foods (bread, pasta, rice, cereal) with vegetables.

Gluten has been shown to increase intestinal permeability allowing toxins to build up in the body. Instead eat 6 to 9 cups of vegetables each day, which will dramatically increase your intake of vitamins and antioxidants. Eating more vegetables and berries (blueberries, blackberries and raspberries) has been shown to improve cognition and mood.

4) Increase omega-3 fatty acid intake.

Omega-3 fatty acids reduce the severity of injury and speed recovery. Eat more wild fish and grass-fed /finished meat; you may also take a fish oil supplement.

5) Eat sufficient protein every day.

The brain uses amino acids from protein to make neurotransmitters. Studies have found that Branch Chain Amino Acids (BCAA’s) have increased recovery after traumatic brain injuries. If you are vegetarian, pay attention to protein intake and also take vitamin B12–many vegetarians are B12 deficient, which can also lead to cognitive and mood problems.

6) Improve nutrition and gut health.

TRS performs testing for nutrient deficiencies. After a traumatic brain injury (TBI) individuals often show decreased levels of vitamin D. Recent research studies has elaborated on the connection between (TBI) and gastrointestinal changes. It has been observed that gut changes often follow a TBI, however this research reports that these intestinal changes may contribute to a higher risk of infection due to increased intestinal permeability and may actually worsen the brain damage in TBI patients.

7) Improve sleep and decrease stress levels.

A concussion causes stress and inflammation. NuCalm reduces stress, thereby reducing inflammation and facilitating the healing response. The effects on human physiology and concussion healing can be determined by using heart rate measurement and heart rate variability (HRV), by enhancing the vagal tone, which reflects the parasympathetic system (rest and relaxation) response.

(HRV) is the easiest way to evaluate the vagal response. This is why (HRV) has become one of the Gold Standards in evaluating concussion healing. The PNS plays a major role in immunity and response to inflammation. It is therefore important in recovery from brain injury healing since the inflammatory response following concussion is responsible for post-concussive symptoms.

When you settle brain inflammation and promote optimal functioning; patients think clearer, mood improves, pain diminishes, energy returns and they are steadily happier. They begin to recover and thrive.

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