Evolving concussion care through active rehabilitation

The Center at Stamford Health, like many concussion clinics, started out of necessity to provide concussion care in their community.

A graduate of the neuropsychology fellowship at the University of Pittsburgh’s Sports Medicine Concussion Program, Christina Kunec, PsyD, Neuropsychologist, was recruited to lead the nascent center. Knowing that a multi-disciplinary model is essential to the treatment of this complex head injury, she assembled a team of providers from Adult and Pediatric Neurology, Integrative Medicine, and Outpatient Rehabilitation to provide complete continuum of care to patients. Jill Walker, PhD, Neuropsychologist, was hired to meet the growing program’s needs, and Caraline Gargiulo, MPS, ATC, ITAT joined the team as ATC/Patient Care Coordinator. They are the only multi-disciplinary team in the area comprised of experts specifically trained in concussion care.

At the Concussion Center, evaluations consist of a detailed clinical interview, neurocognitive testing with ImPACT, and vestibular ocular and balance assessments. These objective assessments provide opportunities to quantify the effects of head injury, measure recovery, and inform referrals to appropriate care providers as necessary.

All members of Stamford’s concussion care team have completed specific concussion training. They regularly attend national conferences and training seminars to stay abreast of new developments within the field. They understand the nature of the injury, and they’re all speaking the same language across disciplines.

Educating patients and improving outcomes

“So much of this head injury is subjective and invisible. We have patients who come from outside providers whose only measure of recovery has been a symptom checklist. Since our team knows what to look for, we're giving them the best chance for a successful recovery.”

The Concussion Center team members provide valuable concussion education in their community, both to athletes and families, as well as to other healthcare providers and members of the school community. They ensure their patients leave appointments with a better understanding of their head injury and a reasonable expectation for recovery. Education helps to demystify this injury, correct misinformation, and reduce anxiety.

Active treatment and rehabilitation to help patients return to activity quickly and safely

They're focusing on active rehabilitation strategies to improve patient outcomes.

Waiting for a concussion to get better can create a lot of anxiety for individuals who are normally always on the go. To that end, they encourage patients to resume light physical activity as soon as possible with a goal of getting them back to school, work, or sport as soon as possible. This approach is empirically supported and sets them apart from other treating clinicians in the area.

“We're looking for the maximum level of activity a patient can do before they become moderately symptomatic. It's the next level of concussion care. The patients appreciate getting active earlier, because they want to get back to their daily lives as soon as possible.”

Looking to the future

Stamford Health’s clinic is working on better identifying the different trajectories of concussion, which leads to better outcomes for patients.

Stamford Health serves as a model for concussion care in the eastern US and beyond. As research on concussion continues to progress, their practice grows to meet their community’s needs.