Scholarlink

Background <p>Post-concussion syndrome is a challenging condition to manage for even the most experienced chronic pain experts. Patients’ presentations are heterogeneous with symptoms spanning physical, cognitive and emotional domains. The symptoms reported are often non-specific, making it difficult for health professionals to prescribe effective rehabilitation. The aim of the present study was to examine the effectiveness of a customized rehabilitation program based on subgroup determination following a standardized clinical exam in adults with post-concussion syndrome.</p> Methods <p>A total of 16 adults (mean age ± SD, 38.3 ± 12.5&#xa0;years) with post-concussion syndrome participated in a 6-week rehabilitation program. Participants were recruited from external community concussion clinics around the greater Toronto area, Canada. Participants underwent a comprehensive standardized clinical exam to subgroup the ostensible symptom generators into either autonomic, cervical or vestibulo-ocular. Customized rehabilitation was then prescribed based on their subgroupings. The primary outcome measure was the Rivermead Post-Concussion Questionnaire (RPQ). Secondary outcome measures included the Patient Health Questionnaire-9 (PHQ-9), the Neck Disability Index (NDI), and exercise tolerance as assessed via the Buffalo Concussion Treadmill Test (BCTT).</p> Results <p>Following 6&#xa0;weeks of customized rehabilitation, participants on average experienced a significant and clinically meaningful change with respect to the RPQ-3 and RPQ-13 (<i>p</i> &lt; 0.001). We also observed a significant change in all secondary outcome measures including a reduction in PHQ-9 (<i>p</i> &lt; 0.01), NDI (<i>p</i> &lt; 0.001) and exercise tolerance, expressed as heart rate threshold (<i>p</i> &lt; 0.001).</p> Conclusion <p>The standardized exam was feasible and useful in assisting the clinician in prescribing effective rehabilitation. The 6-week customized rehabilitation program demonstrated significant changes in patient-reported persistent post-concussion symptoms and exercise tolerance. The implementation of a customized program based on a standardized exam performed to subgroup the ostensible symptom generators may be key to successful management in this population.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Complexity of post-concussion syndrome assessment and management: a case for customizing rehabilitation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月25日

查看全文
  • Nicholas Moser,
  • Milos R. Popovic,
  • Sukhvinder Kalsi-Ryan

摘要

Background

Post-concussion syndrome is a challenging condition to manage for even the most experienced chronic pain experts. Patients’ presentations are heterogeneous with symptoms spanning physical, cognitive and emotional domains. The symptoms reported are often non-specific, making it difficult for health professionals to prescribe effective rehabilitation. The aim of the present study was to examine the effectiveness of a customized rehabilitation program based on subgroup determination following a standardized clinical exam in adults with post-concussion syndrome.

Methods

A total of 16 adults (mean age ± SD, 38.3 ± 12.5 years) with post-concussion syndrome participated in a 6-week rehabilitation program. Participants were recruited from external community concussion clinics around the greater Toronto area, Canada. Participants underwent a comprehensive standardized clinical exam to subgroup the ostensible symptom generators into either autonomic, cervical or vestibulo-ocular. Customized rehabilitation was then prescribed based on their subgroupings. The primary outcome measure was the Rivermead Post-Concussion Questionnaire (RPQ). Secondary outcome measures included the Patient Health Questionnaire-9 (PHQ-9), the Neck Disability Index (NDI), and exercise tolerance as assessed via the Buffalo Concussion Treadmill Test (BCTT).

Results

Following 6 weeks of customized rehabilitation, participants on average experienced a significant and clinically meaningful change with respect to the RPQ-3 and RPQ-13 (p < 0.001). We also observed a significant change in all secondary outcome measures including a reduction in PHQ-9 (p < 0.01), NDI (p < 0.001) and exercise tolerance, expressed as heart rate threshold (p < 0.001).

Conclusion

The standardized exam was feasible and useful in assisting the clinician in prescribing effective rehabilitation. The 6-week customized rehabilitation program demonstrated significant changes in patient-reported persistent post-concussion symptoms and exercise tolerance. The implementation of a customized program based on a standardized exam performed to subgroup the ostensible symptom generators may be key to successful management in this population.