131
AUTUMN
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EARLY WINTER
2016
ESCARPMENTMAGAZINE
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CA
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For sport: the importanceof a comprehensivebaseline
testing...
Ithasbeen recommended that concussiondiagnosis involvedetecting
injurywithout grading severity (mild,moderate, or severe) and that de-
cisions regarding return toplay becomemore individualized. Having
pre-season baseline results topick upon slight alterations in cognitive
andphysical signs followingapotential concussive injury iscrucial toac-
curately identifyingaconcussion.
Administeringamultimodal instrument (onewhichmeasuresvariable
aspectsof cognitiveandphysical function), as soonas reasonablypos-
sible followingapotential injuryandcomparing it to thebaselinepre-in-
jury results is a crucial step in the recognition and rehabilitation of a
concussion.
It is important to understandwhat an athletewas like prior toa sus-
pectedconcussion, inorder to recognize ifpost-injurypresentation isdif-
ferent. There is increasing emphasis beingplacedon the objectivity of
concussionassessmentand thepotentialuseofpre-participationbaseline
scores for comparisonpost-injury. Pre-seasonbaseline scoresarea tool
thatmaybeusedpotentially followinganon field injury. From thebase-
line scores and the subsequent post-injury score one can determine a
change in thepatient’s functional status.
Given the deficits that research has found followinga concussion,
such as reduced reaction time, poor coordination, etc., it is imperative
all aspects that couldbe impactedbya concussionare covered in the
assessmentandsubsequent treatment/management.Therefore,baseline
evaluationsof athletes toensure safe return to sport are recommended.
Abaselineof just oneareaof thebrain, suchasonlycognitive testing is
not enough to ensure that not onlyareathletes’ brains recoveredand
not vulnerable toasecondconcussion,butalso that theirphysical recov-
ery isatoptimal levels toavoidapotential injury.Symptomsalonearea
poor indicator of recovery and therefore baseline objectivemeasures
such as orientation, concentration, reaction time, memory, muscular
strength, balance, visual processing, cognitiveability, andphysical ca-
pacityare required toensurepre-concussion levelsaremet.Havingcom-
prehensivebaseline testingwill benefit parents, doctors and therapists
bydefining theoptimaloutcomesof individual concussionmanagement.
Going forward...
Far toooftenconcussionsgoundiagnosedputting the individual at riskof
further injury.Oncediagnoseda structured, comprehensiveapproach to
rehabilitationand restoringall aspects of apatient’s function, physical,
cognitive, andevenmental health is imperative. Theprocess involves the
collaborationof anumber of healthprofessionals including familyphysi-
cians, physical therapists, optometrists, evenmental healthprofessionals
tohelpaddress stress,depressionandanxietywhichcanariseasa result
ofaconcussion.Althoughrest is important initiallyafteraconcussion injury,
don’t just wait to feel better. Evidence indicates amoreactiveand struc-
turedapproach isbetter. Seekout healthcareprofessionalswith special-
izedcredentialsand training in theareaofconcussionmanagement. Ifyou
are involved incompetitive sports, stronglyconsiderbaselinepre-season.
Testing thebaseline informationcanbeessential inmakingsafedecisions
regarding return toplayand return to learn foryoungathletes.
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Paul Osadzuk, B.Sc., P.T., MCPA
Owner, Physical Therapist | Bayshore Physical Therapy
Rick Thibodeau, B.Sc. Kin., MPT
Registered Physiotherapist | Bayshore Physical Therapy
Carolyn Delkus, BSc. (Ex.Sci.), MPT
Registered Physiotherapist | Bayshore Physical Therapy
