Concussion/TBI

[Amy Sardy]

I have read through your material on this topic, but have recently heard a podcast quoting different protocols for activity following a concussion. My OT friend’s daughter just experienced a concussion and confirmed using a headache/pain scale in her rehab that was the same noted in this podcast. Rather than stop activities when a headache is experienced, this protocol has the patient rate their pain (even if it’s not zero), proceeds with physical activity and only stops if the pain rates more than 2 integers higher than the original rating on a 1-10 scale. Can you confirm?

[Helen Carey]

Concussion seems to be a very fluid topic. Recommendations seem to shift and evolve regularly. For the purpose of this exam, I would stick to the CPG. APPT CPG for concussion

[Danielle Vequist]

I’m confused on this– the APPT CPG for concussion states to rest for 24-48 hours, but the Amsterdam Consensus which is an evidence based-international expert consensus statementt states that light exercise is indicated and important in the first 24-48 hours (if it doesn’t worsen symptoms). Both the CPG and Amsterdam Consensus articles were released in 2022. Should we answer the question based on what the APPT states even though we know it may not be based on the best evidence? I think I know the answer to this question– it’s just really hard to do! 🙂

[Chrissy Durrough Lugge]

Hi Danielle! I’m jumping in because Helen’s response was cut off when the forum closed on Sunday – below are the responses from both Helen and Jessica.

For the PCS exam, it is likely best to stick to the APPT CPG. I think that concussion guidelines are somewhat fluid and tend to evolve frequently, leading to some gray areas in terms of best practice. During the exam, stay focused on the question stem and try not to overthink the question.

Of note, when Jessica and I recently took our respective MOSC recertification exams, they stuck very closely to the CPGs, so that is likely good advice for the initial certification exam, as well!

Chrissy

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