Northw est Area Concussion Aw areness Day Cognitive Rest - - PowerPoint PPT Presentation

Northw est Area Concussion Aw areness Day Cognitive Rest

September 10, 2013 Stephen Evans DO

Concussions Happen

• Sports (per

100,000)

• Football: 64 -76.8
• Boys' ice hockey: 54
• Girl's soccer: 33
• Boys' lacrosse: 40 - 46.6
• Girls' lacrosse: 31 - 35
• Boys' soccer: 19 - 19.2
• Boys' wrestling: 22 - 23.9
• Girls' basketball: 18.6 - 21
• Girls' softball: 16 - 16.3
• Boys' basketball: 16 - 21.2
• Girls' field hockey: 22 - 24.9
• Cheerleading: 11.5 to 14
• Girls' volleyball: 6 - 8.6
• Boys' baseball: Between 4.6 - 5
• Girls' gymnastics: 7
• Girls' swim/dive: 2
• Girls' track/field: 2
• Boys' track/field: 2
• Boys' swim/dive: 1
• Accidents

– Falls – Car Accidents – Bicycles

Pam Oliver Hit on Sideline

Focus on Recovery

• Some of the best information has been

gathered through the NCAA. These are student athletes in academic settings that are well funded.

• Grades, health-status, mental well-

being, and a multitude of other measures have been followed for decades.

What Have They Found?

• Some concussions take more time to

recover- sometimes months or even longer.

• A decline in grades is NOT uncommon.
• Healing times MAY be reduced with

cognitive rest.

So What is Cognitive Rest?

• Decreased school work
• Decreased stress
• Decreased disturbances
• Sounds Great! Sign me up!

What This Really Means

• A individualized lesson plan with

progressive return to regular classroom

• activity. – individualized testing- may

interfere with college plans (SAT’s, etc.)

• No or decreased use of cell phones,

computers, TV, video games, reading,

• r other distractions.

Continued

• Less or no time out with friends.
• No or less chores. (or simplified duties)
• No driving.
• No other sports, swimming

Why?

• The less mental taxing environment on

the brain allows for quicker return to normalcy.

• Restrictions may be slowly progressed

back to normal as the physical limitations are.

Do We Alw ays Need to Do This?

• Not exactly.
• Initially we do.
• In most cases the symptoms resolve quickly

and do not need to continue or add restrictions.

• In cases where people are not improving, the

treatment plan must be individualized.

• http://www.brainsteps.net/_orbs/about/index.

aspx

Take Home Point…Use Your Head… or Rest it…

References

• 1. Giza CC, Hovda DA. The neurometabolic cascade of concussion. J Athl
• Train. 2001;36(3):228-235.
• 2. Broglio SP, Puetz TW. The effect of sport concussion on neurocognitive
• function, self-report symptoms and postural control: a meta-analysis.
• Sports Med. 2008;38(1):53-67.
• 3. Belanger HG, Vanderploeg RD. The neuropsychological impact of
• sports-related concussion: a meta-analysis. J Intl Neuropsychol Soc.
• 2005;11:345-357.
• 4. McCrory P, Johnston KM, Meeuwisse W, et al. Summary and agreement
• statement of the 2nd International Conference on Concussion
• in Sport, Prague 2004. Clin J Sport Med. 2005;15(2):48-55.
• 5. McCrory P, Meeuwisse W, Johnston K, et al. Consensus statement on
• concussion in sport: the 3rd International Conference on Concussion
• in Sport held in Zurich, November 2008. Br J Sports Med. May 2009;43
• Suppl 1:i76-90.
• 6. Logan K. Cognitive rest means I can’t do what?! Athl Train Sports
• Health Care. 2009;1(6):251-252.
• 7. Purcell L. What are the most appropriate return-to-play guidelines for
• concussed child athletes? Br J Sports Med. May 2009;43 Suppl 1:i51-55.
• 8. Centers for Disease Control and Prevention, National Center for Injury
• Prevention and Control. Heads Up: Brain Injury in Your Practice. A Tool
• Kit for Physicians. Available at: http://www.cdc.gov/ncipc/tbi/physicians_tool_kit.htm. Accessed November 15, 2009.