Implementation of Return to Learn Protocols for Student Athletes with Sport and Recreation Related Concussion: An Integrative Review of Perceptions, Challenges and Successes

2021 ◽  
pp. 105984052110566
Author(s):  
Joseph Fetta ◽  
Angela Starkweather ◽  
Robert Huggins ◽  
Thomas Van Hoof ◽  
Douglas Casa ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
The United States ◽  
Integrative Review ◽  
Communication Breakdown ◽  
Return To Learn ◽  
Academic Workload ◽  
Sport And Recreation ◽  
Stakeholder Communication

Concussion or mild traumatic brain injury (mTBI) is a common phenomenon in the United States, with up to 3.6 million sport-related mTBIs diagnosed annually. Return to learn protocols have been developed to facilitate the reintegration of students into school after mTBI, however, the implementation of return to learn protocols varies significantly across geographic regions and school districts. An integrative review of the literature was performed using Whittemore and Knalf's methodology. A search of published literature was conducted using the PRISMA checklist. Database searches were conducted from March 2,019 to October 2,021 using the terms “mild traumatic brain injury” and “return to learn.” Twenty-eight publications were included. Three themes were derived from this review: lack of policy, poor staff education on concussion symptoms and stakeholder communication breakdown. The development of communication patterns and use of a return to learn protocol could facilitate a gradual return to full academic workload after concussion.

scholarly journals Heart Rate Variability and Mild Traumatic Brain Injury: Case Study and Review of Literature

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S2.2-S2
Author(s):  
Harrison Seltzer ◽  
Karim Elghawy ◽  
Robert Baker
Keyword(s):  
Traumatic Brain Injury ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Training Session ◽  
The United States ◽  
Smart Device ◽  
Cross Country

ObjectiveUse biofeedback measures to manage a patient's long term recovery from concussion.BackgroundSports-related mild traumatic brain injury (MTBI) is estimated to affect 3.8 million people in the United States. Identifying quantitative measures of recovery has become a point of interest in treatment. Heart Rate Variability (HRV), the average fluctuation in the interval between heartbeats, shows promise as a noninvasive biomarker.Design/MethodsCase report following cardiovascular recovery of a 15 year old cross country runner 4 months post-injury. Average heart rate and maximum heart rate per training session were collected from the patient's smart device.ResultsA 15-year-old Caucasian male cross-country runner hit the back of his head during a soccer game suffering an MTBI. The patient rested from the activity for 1 week then returned to training. Two months after the injury the patient complained of persistent shortness of breath, fatigue, and increased heart rate while running. According to the patient, his average BPM while running prior to the injury was in the 160s. The patient's smart device post-concussion reports a spike into the 180s. 3 months post-concussion the patient was instructed to keep his heart rate below 170 during training. In the following month, the patient's condition improved gradually with a return to baseline activity.ConclusionsHRV is a promising point of investigation for the management of post-concussive symptoms. Further research is necessary to elucidate the long term effects of concussion on heart rate variability.

scholarly journals Mild traumatic brain injury in the United States, 1998–2000

Brain Injury ◽  
2005 ◽  
Vol 19 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Jeffrey J. Bazarian ◽  
Jason Mcclung ◽  
Manish N. Shah ◽  
Yen Ting Cheng ◽  
William Flesher ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
The United States

scholarly journals Working with Mild Traumatic Brain Injury: Voices from the Field

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Page Walker Buck ◽  
Rebecca G. Laster ◽  
Jocelyn Spencer Sagrati ◽  
Rachel Shapiro Kirzner
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
The United States ◽  
Public Health Issue ◽  
Professional Literature ◽  
Rehabilitation Professionals ◽  
Rehabilitation Protocols ◽  
Developing Area ◽  
Physical Consequences

Mild traumatic brain injury (mTBI), also known as concussion, is an emerging public health issue in the United States. The estimated annual 1.2 million individuals who sustain this injury face a range of cognitive, psychological, and physical consequences for which rehabilitation protocols are being developed and implemented. On the frontlines of this developing area of rehabilitation work are professionals in a range of therapeutic settings whose practice wisdom has yet to be shared in the professional literature. This qualitative study aimed to fill this gap by exploring the experiences and insights of rehabilitation professionals serving mTBI patients in outpatient, civilian settings. An analysis of the qualitative data revealed five themes common in mTBI work, providing an in-depth look at this often challenging field of rehabilitation.

Assessing Mild Traumatic Brain Injury

1998 ◽  
Vol 3 (6) ◽  
pp. 1-5 ◽  
Author(s):  
Nathan D. Zasler ◽  
Michael F. Martelli
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Disease Process ◽  
The United States ◽  
Physical Symptoms ◽  
The Body ◽  
Loss Of Consciousness ◽  
Ideal System

Abstract Mild traumatic brain injury (MTBI) accounts for approximately 80% of the estimated 373000 traumatic brain injuries that occur annually in the United States. MTBI typically occurs in males 15 to 24 years of age, and postconcussional sequelae may impede physical, emotional, social, marital, vocational, and avocational functioning. Usually the severity of the initial neurologic injury is defined according to the Glasgow Coma Score, the presence and duration of amnesia (retrograde and anterograde), and the alteration of loss of consciousness and its duration. MTBI is a traumatically induced physiological disruption of cerebral function manifested by at least one of the following: loss of consciousness no longer than 20 minutes; any loss of memory; any alteration in mental status at the time of the accident; physical symptoms that potentially are related to the brain; and development of posttraumatic cognitive deficits not accounted for by emotional factors. When a patient presents with multisystem trauma, impairments may involve several parts of the body, including the nervous system. Individual impairments of other systems should be calculated separately and their whole person values combined using the Combined Values Chart in AMA Guides to the Evaluation of Permanent Impairment. At present, no ideal system can rate impairment following MTBI, and physicians must thoroughly understand both the underlying disease process and the associated injuries.

scholarly journals The nonsurgical nature of patients with subarachnoid or intraparenchymal hemorrhage associated with mild traumatic brain injury

2015 ◽  
Vol 123 (3) ◽  
pp. 649-653 ◽  
Author(s):  
Benjamin J. Ditty ◽  
Nidal B. Omar ◽  
Paul M. Foreman ◽  
Daxa M. Patel ◽  
Patrick R. Pritchard ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Average Distance ◽  
Clinical Care ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
The United States ◽  
Intraparenchymal Hemorrhage ◽  
Gcs Score

OBJECT Mild traumatic brain injury (mTBI), as defined by Glasgow Coma Scale (GCS) score of 13 or higher, is a common problem in the United States and worldwide, estimated to affect more than 1 million patients yearly. When associated with intracranial hemorrhage, it is a common reason for neurosurgical consultation and transfer to tertiary care centers. The authors set out to investigate the clinical implications of subarachnoid hemorrhage (SAH) and/or intraparenchymal hemorrhage (IPH) associated with mTBI in hopes of standardization of mTBI clinical care and optimization of resource allocation. METHODS The authors performed a retrospective review of 500 consecutively treated patients with mTBI and SAH and/or IPH admitted to a Level I trauma center in Alabama between May 2003 and May 2013. They performed a review of medical records to confirm the diagnosis, determine neurological condition at admission, and assess for episodes of neurological decline or brain injury–related complications including altered mental status, seizures, and hyponatremia. RESULTS Of the 500 patients for whom data were reviewed, 304 (60.8%) were male and 196 (39.2%) were female. Average age was 46.3 years. Overall, 63 patients (12.6%) had isolated IPH, 411 (82.2%) had isolated SAH, and 26 (5.2%) had radiographic evidence of both IPH and SAH. One hundred forty-five patients (29%) were transferred an average distance of 64.5 miles. The authors identified no patients who experienced neurological worsening during their hospital course. Two patients experienced hyponatremia that required treatment with sodium supplementation. CONCLUSIONS Patients with the constellation of SAH and/or IPH and mTBI do not require neurosurgical consultation, and these findings should not be used as the sole criteria to justify transfer to tertiary referral centers.

Mild traumatic brain injury in the United States: demographics, brain imaging procedures, health-care utilization and costs

Brain Injury ◽  
2019 ◽  
Vol 33 (9) ◽  
pp. 1151-1157 ◽  
Author(s):  
Vladislav Pavlov ◽  
Philippe Thompson-Leduc ◽  
Louise Zimmer ◽  
Jody Wen ◽  
Jerome Shea ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Care Utilization ◽  
Brain Imaging ◽  
Mild Traumatic Brain Injury ◽  
The United States ◽  
Care Utilization ◽  
Imaging Procedures

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

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