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Physical therapist's role in concussion management

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Physical therapist's role in concussion management

Physical therapists are important members of any concussion care team. They participate in active rehabilitation to help patients get better. Physical therapists are most commonly involved in Vision, Vestibular, and Cervical Spine rehabilitation.

 

VISION THERAPY

1/3 of people with concussions experience visual problems.
Top 10 vision therapy techniques for concussions:

  1. Pencil Push Ups
  2. Pointer and Straw
  3. Brock String
  4. 3 Dot Card
  5. Life Saver Card
  6. HART Chart
  7. Marsden Ball
  8. Rotator Pegboard
  9. Michigan Tracking
  10. Thumb Pursuits and Saccades

 

VESTIBULAR THERAPY

At least half of concussed patients will experience balance or vestibular issues after concussion. Use the Balance Error Scoring System (BESS) to identify balance issues in your patients.
  • Stances (on both firm and foam surfaces):
    • Double Leg
    • Single Leg
    • Tandem
  • Count the number of errors:
    • Moving hands off iliac crests
    • Opening eyes
    • Step, stumble, or fall
    • Abduction or flexion of hip beyond 30 degrees
    • lifting forefoot or heel off surface
    • Remaining out of testing position for more than five seconds

 

CERVICAL SPINE

PTs are integral to identifying and rehabilitating cervical spine deficits after concussion. Some techniques to use:

  1. Upper quarter screen
  2. Postural assessment
  3. Neurological testing
  4. Ligamentous instability testing
  5. AROM
  6. Vertebrobasilar insufficiency testing
  7. Joint mobility assessment
Pro tip: Make sure you can differentiate between concussion symptoms and whiplash associated disorder. 25% of whiplash patients have persistent symptoms that mimic concussion symptoms.

NEED TRAINING?

Join other physical therapists who have become concussion management leaders by earning their ImPACT Trained Physical Therapist (ITPT) credential.

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