scholarly journals Concussion Recovery Phase Affects Vestibular and Oculomotor Symptom Provocation

2017 ◽  
Vol 39 (02) ◽  
pp. 141-147 ◽  
Author(s):  
Kelly Cheever ◽  
Jane McDevitt ◽  
Ryan Tierney ◽  
W. Wright
Keyword(s):  
Recovery Process ◽  
Recovery Phase ◽  
Return To Play ◽  
Initial Assessment ◽  
Valuable Insight ◽  
Gaze Stabilization ◽  
Symptom Provocation ◽  
Acute Group ◽  
Time Requirements ◽  
Concussion Recovery

AbstractVestibular and oculomotor testing is emerging as a valuable assessment in sport-related concussion (SRC). However, their usefulness for tracking recovery and guiding return-to-play decisions remains unclear. Therefore the purpose of this study was to evaluate their clinical usefulness for tracking SRC recovery. Vestibular and oculomotor assessments were used to measure symptom provocation in an acute group (n=21) concussed≤10 days, prolonged symptoms group (n=10) concussed ≥16 days (median=84 days), healthy group (n=58) no concussions in >6 months. Known-groups approach was used with three groups at three time points (initial, 2-week and 6-week follow-up). Provoked symptoms for Gaze-Stabilization (GST), Rapid Eye Horizontal (REH), Optokinetic Stimulation (OKS), Smooth-Pursuit Slow (SPS) and Fast (SPF) tests, total combined symptoms scores and near point convergence (NPC) distance were significantly greater at initial assessment in both injury groups compared to controls. Injury groups improved on the King-Devick test and combined symptom provocation scores across time. The acute group improved over time on REH and SPF tests, while the prolonged symptoms group improved on OKS. A regression model (REH, OKS, GST) was 90% accurate discriminating concussed from healthy. Vestibular and ocular motor tests give valuable insight during recovery. They can prove beneficial in concussion evaluation given the modest equipment, training and time requirements. The current study demonstrates that when combined, vestibular and oculomotor clinical tests aid in the detection of deficits following a SRC. Additionally, tests such as NPC, GST, REH, SPS, SPF OKS and KD provide valuable information to clinicians throughout the recovery process and may aid in return to play decisions.

Concussion and the College Athlete

2015 ◽  
Author(s):  
Paul Comper ◽  
Mike Hutchison
Keyword(s):  
Recovery Process ◽  
Return To Play ◽  
Professional Athletes ◽  
College Level ◽  
Central Theme ◽  
College Athlete ◽  
University Level ◽  
Psychosocial Challenges ◽  
Concussion Recovery ◽  
Serious Injury

Concussion is a common and serious injury among college/university level athletes. Similar to professional athletes, a central theme for most college level athletes is to be able to quickly but safely return to play following concussion. However, unlike professional athletes who earn their living playing sports, most college level athletes will move into other careers or professions once their playing career ends. College athletes therefore have a dual role, with academics and “returning to learn” being a component equally important as return to play in the concussion recovery process. This article describes some of the issues in developing and implementing a university concussion program, as well as issues and common difficulties facing college level athletes as they encounter the acute physical, neuropsychological, and psychosocial challenges related to concussive injuries.

Effects of Concussion Recovery Phase on Symptom Provocation using Vestibular and Assessments.

2017 ◽  
Vol 49 (5S) ◽  
pp. 526
Author(s):  
Kelly Cheever ◽  
Jane McDevitt ◽  
Ryan Tierney ◽  
W Geoffrey Wright
Keyword(s):  
Recovery Phase ◽  
Symptom Provocation ◽  
Concussion Recovery

613Pediatric Burn Bibliotherapy - An Initial Assessment of Novels About Young Burn Survivors and Their Collective Experiences

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S160-S160
Author(s):  
Philip H Chang ◽  
Antonella Barrios ◽  
Jamie Heffernan ◽  
Angela Rabbitts ◽  
Caroline Jedlicka
Keyword(s):  
Performing Arts ◽  
English Language ◽  
Psychosocial Support ◽  
Numerical Data ◽  
Recovery Phase ◽  
Initial Assessment ◽  
Burn Patients ◽  
The Past ◽  
Burn Survivors ◽  
Burn Patient

Abstract Introduction Bibliotherapy is the use of books as a therapeutic intervention for structuring interaction between facilitator and participant based on the mutual sharing of literature. Bibliotherapy has been utilized to address childhood teasing, healthy lifestyles in children, and eating disorders. With the dramatic improvements in survival of burn patients over the past decades, biographies and novels featuring pediatric burn survivors have emerged. These patients often face significant barriers in accessing psychosocial support. Our team hypothesized that bibliotherapy could benefit pediatric burn patients. In order to test this hypothesis, as a first step, our team conducted an assessment of the available burn survivor literature. Methods WorldCat book database was queried using the terms “Burn Patient Fiction” (45 results) and “Burn Patient Biography” (53 results). The authors identified 12 books out of these 98 results likely to be appropriate for adolescent and teenage burn patients based on the brief summaries. The 12 books were then read by the research team and analyzed for burn patient demographics and relevant clinical data when available. Simple descriptive statistics were utilized for numerical data Results Out of 12 books read, 5 were biographies & 7 fictional novels. Protagonists mean age at time of injury was 8.7±5.1 years (range 2–16), with 5 males and 7 females. Average injury size was 57±21% TBSA (range: 14–85). 10 of 12 protagonists suffered facial burns; 7 of 12 suffered hand burns. Oral health/dental issues were described in 4 of 12 books. Geographically, these English language novels spanned Australia (1), Canada 92), and the U.S. (9). Average page length was 237±88 pages (range: 64–372). In 11 of 12 books, mechanism of injury involved flame from car accidents (2), house fires (4), and campfires (2). With regards to sources of positive support during the recovery phase, family was the most commonly cited source (11 novels) followed by friends (10), spiritual/religious support (5), sports (3), burn survivor groups (3), hospital psychiatrists (3), and performing arts (2). Appropriate audience group for most books were teenagers (11) with 5 books deemed also appropriate for adults (only 1 book judged appropriate only for adults), and 2 books appropriate for adolescents. Conclusions Several novels and biographies with pediatric burn survivor protagonists have been written over the past 20 years. Commonalities across these books include flame burn etiology, relatively large TBSA, and burn injuries to visible body areas (face and hand). Family and friends were the most common emotional support for these protagonists. Most books were appropriate for teenagers.

scholarly journals Investigating the effect of the body mass index (BMI) values on the behavior of human energy expenditure

2020 ◽  
Vol 18 (5) ◽  
Author(s):  
Sugiono Sugiono ◽  
Sudjito Suparman ◽  
Teguh Oktiarso ◽  
Willy Satrio
Keyword(s):  
Heart Rate ◽  
Energy Expenditure ◽  
Rest Heart Rate ◽  
Critical Factor ◽  
Recovery Process ◽  
Recovery Phase ◽  
The Body ◽  
Office Workers ◽  
Healthy Weight ◽  
Human Energy

Employee durability is a critical factor to improve a company performance. Company management must control employee health conditions. The purpose of this paper is to determine the effect of office worker’s BMI variation on human energy expenditure behavior including the recovery process. This study started with literature reviews of BMI, human biology, energy expenditure, and physiology ergonomics. The data was collected randomly from 126 nonphysical office workers in productive ages from 20 to 40 years old. The BMI, resting heart rate, activity heart rate, and recovery heart rate of all respondents then recorded. The results shows that the respondents BMI scores are classified into underweight (BMI <18.5) with totaling = 4%, healthy weight (18.5 ≤ BMI ≤ 22.9) = 34.1%, light obesity (23 ≤ BMI ≤ 24.9) = 23%, medium obesity (25 ≤ BMI ≤ 29.9) = 29.4%, and weight obesity (BMI> 30) = 9.5%. The underweight class has the lowest average rest heart rate = 68.6 bpm and the overweight class has the highest average rest heart rate = 84.6 bpm. Consequently, heart rate during activity for each class from underweight to overweight is 88.4 bpm, 90.9 bpm, 93.3 bpm, 95.1 bpm, and 98.6 bpm. With the same order, the heart rate reduction percentage during the recovery phase is 4.6%, 11.0%, 13.1%, 16.0%, and 8.8%. In brief, the BMI variation strongly correlated with Time to Recovery (TTR) of nonphysical office workers.

Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery

2007 ◽  
Vol 16 (3) ◽  
pp. 244-259 ◽  
Author(s):  
Michelle Cleary ◽  
Daniel Ruiz ◽  
Lindsey Eberman ◽  
Israel Mitchell ◽  
Helen Binkley
Keyword(s):  
High School ◽  
Differential Diagnosis ◽  
Previous History ◽  
Football Player ◽  
Return To Play ◽  
Initial Assessment ◽  
Severe Dehydration ◽  
Exertional Rhabdomyolysis ◽  
Hospitalization Period ◽  
Return To Activity

Objective:We present a case of severe dehydration, muscle cramping, and rhabdomyolysis in a high school football player followed by a suggested program for gradual return to play.Background:A 16-year-old male football player (body mass = 69.1 kg, height = 175.3 cm) reported to the ATC after the morning session on the second day of two-a-days complaining of severe muscle cramping.Differential Diagnosis:The initial assessment included severe dehydration and exercise-induced muscle cramps. The differential diagnosis was severe dehydration, exertional rhabdomyolysis, or myositis. CK testing revealed elevated levels indicating mild rhabdomyolysis.Treatment:The emergency department administered 8 L of intravenous (IV) fluid within the 48-hr hospitalization period, followed by gradual return to activity.Uniqueness:To our knowledge, no reports of exertional rhabdomyolysis in an adolescent football player exist. In this case, a high school quarterback with a previous history of heat-related cramping succumbed to severe dehydration and exertional rhabdomyolysis during noncontact preseason practice. We provide suggestions for return to activity following exertional rhabdomyolysis.

scholarly journals Preliminary Evidence-Based Recommendations for Return to Learn: a novel pilot study tracking concussion recovery in college students

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S33.3-S34
Author(s):  
Zachary Bevilacqua ◽  
Mary Kerby ◽  
David Fletcher ◽  
Zhongxue Chen ◽  
Becca Merritt ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Design ◽  
Text Messages ◽  
Return To Play ◽  
Evidence Based ◽  
Full Time ◽  
Symptom Resolution ◽  
Phone Calls ◽  
Return To Learn ◽  
Concussion Recovery

ObjectiveInvestigate the potential factors influencing resolution of chief concussion symptoms in a longitudinal design. Second, assess subjects’ perception of their concussion recovery and what types of activities and accommodations appeared beneficial.BackgroundAthletes re-entering the academic setting after a concussion is commonly referred as return-to-learn (RTL), which has appeared secondary to the abundantly researched return-to-play protocols implemented ubiquitously. Importantly, every concussed collegiate, adolescent, and pediatric athlete is first and foremost a student-athlete, with “student” holding the emphasis. To date, very few studies have examined the RTL aspect of concussion recovery, and the effects premature classroom attendance may cause.Design/MethodsNine concussed, college aged (18-26 years), full-time students were monitored longitudinally throughout their recovery from diagnosis to full symptom-free academic participation. Symptom severity for five prevalent symptoms were recorded 4 times per day, along with a daily phone call to report participant’s diet, duration of screen-time usage and music listened to, physical activity participation, and types of classes attended.ResultsResponse rates to text messages and phone calls yielded a mean 92% and 93% respectively across the nine subjects. Additionally, five variables were significantly associated with symptom resolution (music, sleep, physical activity, water, and time) (p = 0.0004 to p = 0.036). Lastly, subjects reported math and computer-oriented courses as the most difficult (33% and 44% respectively). Additional time on assignments/exams and reducing screen brightness were the most beneficial accommodations (66% and 56% respectively).ConclusionsOur findings introduce a novel and robust approach to monitoring concussed students throughout their recovery. Furthermore, this methodology is the first to produce holistic evidence-based results concerning re-integrating students to the classroom. Lastly, it appears that dietary and social behaviors can indeed influence symptom resolution.

scholarly journals Objective Functional Assessment After a Head Injury Using Movement and Activity in Physical Space Scores: A Case Report

2014 ◽  
Vol 49 (4) ◽  
pp. 568-575 ◽  
Author(s):  
James L. Farnsworth ◽  
Danielle McElhiney ◽  
Shannon David ◽  
Gaurav Sinha ◽  
Brian G. Ragan
Keyword(s):  
Athletic Training ◽  
Objective Measure ◽  
Physical Space ◽  
Recovery Process ◽  
Living Environment ◽  
Return To Play ◽  
Functional Score ◽  
Gps Receiver ◽  
Novel Approach ◽  
Objective Functional

Objective: To describe the potential benefit of using a global positioning system (GPS) and accelerometry as an objective functional-activity measure after concussion by creating Movement and Activity in Physical Space (MAPS) scores. Background: A 21-year-old female soccer player suffered a blow to the back of the head from an opponent's shoulder during an away match. No athletic trainer was present. She played the remainder of the match and reported to the athletic training facility the next day for evaluation. Differential Diagnosis: Concussion. Treatment: The athlete was removed from all athletic activities. Her symptoms were monitored based on the Zurich guidelines. She was also instructed to wear an accelerometer on her hip and to carry an on-person GPS receiver at all times for 10 days. Her total symptom scores for the 4 symptomatic days were 82, 39, 49, and 36. Her mean MAPS functional score for symptomatic days 3 through 5 was 900.9 and for asymptomatic days 6 through 11 was 2734.9. Uniqueness: We monitored the patient's function during the concussion-recovery process using an on-person GPS receiver and accelerometer to calculate personalized MAPS scores. This novel approach to measuring function after injury may provide a useful complementary tool to help with return-to-play decisions. Conclusions: An on-person GPS receiver and accelerometer were used to observe the patient's physical activity in a free-living environment, allowing for an objective measure of function during recovery. Her MAPS scores were low while she was symptomatic and increased as she became asymptomatic. We saw the expected inverse relationship between symptoms and function. In situations where accuracy of reported symptoms may be a concern, this measure may provide a way to verify the validity of, or raise doubts about, self-reported symptoms.

scholarly journals Potential factors influencing recovery from concussion in collegiate student-athletes

2017 ◽  
Vol 1 ◽  
pp. 205970021770708 ◽  
Author(s):  
Kayla P Harvey ◽  
Eric E Hall ◽  
Kirtida Patel ◽  
Kenneth P Barnes ◽  
Caroline J Ketcham
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Student Athletes ◽  
Return To Play ◽  
Hyperactivity Disorder ◽  
Previous Diagnosis ◽  
History Of ◽  
Concussion Recovery ◽  
Potential Factors

Background Factors including sex, previous diagnosis of migraines, previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, and a history of concussion may influence the length of recovery from concussion in collegiate student-athletes. Purpose To better understand factors that may influence recovery from concussion in collegiate-student athletes. Methods A total of 91 student-athletes from a Division I NCAA University who sustained concussions from the fall of 2011 to the spring of 2015 were evaluated. They were considered recovered from their concussion when neurocognitive and symptom scores returned to baseline and they were cleared by their physician. Analyses of variance were conducted to determine if potential factors influenced concussion recovery ( p < .0125). Results No significant differences were found for sex (males = 7.4 ± 5.9; females = 8.3 ± 4.8 days; p = 0.417), previous diagnosis of migraines (diagnosis = 8.0 ± 5.7; no diagnosis = 7.8 ± 5.4 days; p = 0.926), or history of concussion (history = 8.3 ± 5.7; no history = 5.6 ± 3.4 days; p = 0.088). However, a significant difference in the length of recovery was found between those with a previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and those without (diagnosis = 13.3 ± 7.3; no diagnosis = 7.3 ± 4.9 days; p = 0.002). Conclusion Student-athletes with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder show significantly longer recovery from concussions than those without. Further investigation of this and other factors that influence recovery from concussion may help in concussion recovery and return-to-play guidelines that improve student-athlete well-being.

scholarly journals On-Field Signs and Symptoms Associated With Recovery Duration After Concussion in High School and College Athletes: A Critically Appraised Topic

2015 ◽  
Vol 24 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Jaebin Shim ◽  
Deanna H. Smith ◽  
Bonnie L. Van Lunen
Keyword(s):  
High School ◽  
College Athletes ◽  
Signs And Symptoms ◽  
Recovery Process ◽  
Return To Play ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Duration Of Symptoms ◽  
Wide Range ◽  
Recovery Times

Clinical Scenario:Over the past decade, sport-related concussions have received increased attention due to their frequency and severity over a wide range of athletics. Clinicians have developed return-to-play protocols to better manage concussions in young athletes; however, a standardized process projecting the length of recovery time after concussion has remained an elusive piece of the puzzle. The recovery times associated with such an injury once diagnosed can last anywhere from 1 wk to several months. Risk factors that could lead to protracted recovery times include a history of 1 or multiple concussions and a greater number, severity, and duration of symptoms after the injury. Examining the possible relationship between on-field or sideline signs and symptoms and recovery times would give clinicians the confident ability to properly treat and manage an athlete’s recovery process in a more systematic manner. Furthermore, identifying factors after a head injury that may be predictive of protracted recovery times would be useful for athletes, parents, and coaches alike.Focused Clinical Question:Which on-field and sideline signs and symptoms affect length of recovery after concussion in high school and college athletes?

scholarly journals Adolescents With ADHD Do Not Take Longer to Recover From Concussion

2021 ◽  
Vol 8 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson ◽  
Bruce Maxwell ◽  
Ross Zafonte ◽  
Paul D. Berkner
Keyword(s):  
Recovery Time ◽  
Return To Play ◽  
Return To School ◽  
Prior History ◽  
Return To Sports ◽  
Full Time ◽  
Recovery Times ◽  
Concussion History ◽  
Concussion Recovery ◽  
Medication Status

The objective of this study was to determine whether adolescents with attention-deficit/hyperactivity disorder (ADHD) have prolonged return to school and sports following concussion compared to those without ADHD and whether medication status or concussion history is associated with recovery time. We hypothesized that having ADHD would not be associated with longer recovery time. This prospective observational cohort study, conducted between 2014 and 2019, examined concussion recovery among school sponsored athletics throughout Maine, USA. The sample included 623 adolescents, aged 14–19 years (mean = 16.3, standard deviation = 1.3 years), 43.8% girls, and 90 (14.4%) reported having ADHD. Concussions were identified by certified athletic trainers. We computed days to return to school (full time without accommodations) and days to return to sports (completed return to play protocol) following concussion. Adolescents with ADHD [median days = 7, interquartile range (IQR) = 3–13, range = 0–45] did not take longer than those without ADHD (median days = 7, IQR = 3–13, range = 0–231) to return to school (U = 22,642.0, p = 0.81, r = 0.01; log rank: χ12 = 0.059, p = 0.81). Adolescents with ADHD (median days = 14, IQR = 10–20, range = 2–80) did not take longer than those without ADHD (median days = 15, IQR = 10–21, range = 1–210) to return to sports (U = 20,295.0, p = 0.38, r = 0.04; log rank: χ12 = 0.511, p = 0.48). Medication status and concussion history were not associated with longer recovery times. Adolescents with ADHD did not take longer to functionally recover following concussion. Recovery times did not differ based on whether adolescents with ADHD reported taking medication to treat their ADHD or whether they reported a prior history of concussion.

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