Complete Concussion Management Inc. is a concussion research company that educates healthcare practitioners on evidence-based concussion therapies and management strategies so they may provide high-quality concussion programs and cutting-edge rehabilitation to athletes and concussed patients across Canada.
What is baseline testing?
The first, and by far the most important step in properly managing concussions comes before the injury happens. Actually, before the season even starts! A “baseline test” is a test that is done BEFORE a concussion happens.
The purpose of a baseline test is to measure every area of brain function, which could become affected following a concussion. This way, if an athlete does get a concussion, we can compare their post-injury state to their baseline parameters to help make an accurate diagnosis, as well as to establish when they are fully healthy and are safe to return to their sport. Without these baseline parameters we have no way of determining when the brain has fully recovered.
The initial concussion is generally not a large concern, especially since our certified practitioners are highly trained to treat and manage these injuries. However, it is a second concussion, sustained prior to full recovery of the initial concussion, that is a cause for concern as this may result in long term brain damage or other larger consequences. Ensuring every athlete has a baseline test done before their season starts is the first step in decreasing the greater risk of concussions.
Professional sports organizations have been undergoing pre-season baseline testing for years, however, comprehensive testing of this magnitude has never been available to youth and amateur sports associations; partly because most healthcare practitioners are not sure where to start.
Complete Concussion Management™ has solved this problem by providing accessible, comprehensive, research-proven pre-season and post-injury concussion evaluations, diagnosis and treatment, for individuals, athletes and sports associations in local communities across Canada and PEAK PERFORMANCE PHYSIOTHERAPY is now affiliated with CCM!!
In the immediate post-injury phase, there is no other treatment for concussion other than REST. A concussion or a mild traumatic brain injury (mTBI), is essentially an energy deficit inside the brain, complete with ion imbalances and blood flow abnormalities. Rest has two very important features when it comes to concussion. First, it keeps the athlete from putting themselves in harms way until they have recovered sufficiently to avoid a devastating second injury. Secondly, rest allows the athlete to get a jump-start on their recovery so that all available energy is allocated to helping recover imbalanced brain cells.
The general consensus within the research and medical community is, anything that could potentially burn energy, such as mental stimulation or concentration as well as physical exercise, will in-turn delay recovery! Therefore, COMPLETE PHYSICAL and COGNITIVE REST is prescribed during the initial recovery period. This means: no school, no homework, no texting, no computer/video games, no television, no physical activity. Often times, athletes are encouraged to sit in a dark room so that they are free from light stimulation (this is not necessary, but the patient may prefer this if they are light sensitive).
The use of medications should be reserved for extreme circumstances and should only be used if directly prescribed by a physician who is familiar with concussion injuries.
The next stages of rehabilitation from a concussion injury involve a gradual return, first to cognitive activity and then a gradual increase in physical activity, with each stage separated by a period of at least 24 hours (Click here for more information). This process must be monitored by a clinician with extensive training in concussion injuries, as there are numerous signs which could delay recovery if not properly addressed. The athlete must have NO SYMPTOMS at any one of the stages in order to be progressed to the next stage. If symptoms are encountered, this is indication of not being ready for the complexity of the task, and the athlete should drop back to the previous stage for a 24-hour period before attempting the next stage again. The final stages involve monitored increases in physical exertion to assess blood flow within the brain, as well as extensive testing of neurological, mental and physical systems, to ensure that your brain has recovered and you are safe to return to activity without causing further damage.
Post-concussion syndrome is when your concussion symptoms are persistent, beyond a 1 month period. There are numerous rehabilitation and treatment options available for patients, which are dependent on where the dysfunctions or symptoms lie. Certified Complete Concussion Management practitioners have extensive training in the treatment and rehabilitation of chronic concussion symptoms such as ongoing headaches, balance/dizziness issues, visual disturbances, reading difficulties, trouble concentrating, visual motion sensitivity, etc. For very complex cases, we have a referral network of various specialists in many regions of the country that can be accessed should your case require additional or extensive care. These referral sources meet various rehabilitation needs of post-concussion syndrome such as vestibular and motor coordination rehab for ongoing balance impairment, visual rehabilitation, cervical proprioceptive training, cognitive behavioural therapy, monitored heart-rate specific exercise programs to increase blood flow and oxygenation to the brain tissue, neurocognitive rehabilitation for problems with memory and attention, or medication if need be.
Return-to-learn is a relatively new concept that deals with the reintegration of student athletes back into mental activity and learning following a concussion. Concussions can have a significant short-term impact on a students memory and concentration abilities, often times grades begin to suffer if this process is not dealt with appropriately. Our trained clinicians offer a stepwise reintegration back into the school environment through modifications and communication with teaching and school administrative staff. Our program offers rehabilitation programs for students that are having difficulty with certain aspects of brain function.
Similar to return-to-learn, the return-to-work program offers a stepwise reintegration back into the working environment for concussed patients.
Following a concussion, return-to-play is a stepwise process, which gradually introduces the athlete back into their specific sporting environment. This process gradually reintroduces varying degrees of physical and sport specific activity, assessing recovery of abnormal brain blood flow and/or vestibular function. This stepwise approach is capped off with a final physical test, designed by the Chicago Blackhawks medical staff. In addition to re-testing all pre-injury cognitive and physical measures, this test assesses an individual’s level of recovery and ability to return to full game play.
The most important step in this process is the final testing, which is compared to the results of your baseline test that is done prior to starting each season. Without knowing what your memory, concentration, balance, visual tracking speed, processing abilities, reaction time, etc. was when you were healthy, it is very difficult to truly know when you have recovered following a brain injury. Please get a proper baseline test done every year BEFORE you start your season!
Book a Baseline test with Peak Performance Physiotherapy.
[the information contained has been reprinted, with permission, from Complete Concussion Management.]