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In October 2016, world leaders in the field of sport-related concussion (SRC), of which a large proportion are Canadian, met in Berlin to develop the latest statement on our current knowledge of the science of SRC. As a quick review, an SRC is a traumatic brain injury induced by biomechanical force transmitted to head causing functional disturbance. It does not require a direct blow to the head. Some of the new developments and highlights from the statement include:
– Assessment of mental status, cognitive functioning, sleep/wake disturbance, ocular function, vestibular function, gait, and balance is recommended
– Insufficient evidence for investigations such as EEG or MRI
– A new Sports Concussion Assessment Tool Version 5 (SCAT) was developed
– A brief period (24–48 hours) of cognitive and physical rest is appropriate for most patients
– Subsymptom threshold activities and submaximal exercise are encouraged (as long as symptoms are not exacerbated)
– Cervical spine rehab is recommended for neck pain/headaches
– Vestibular rehab is recommended for dizziness
– Return-to-play and return-to-school/work protocols can advance in parallel
– Children and adolescents should not return to sport until they have successfully returned to school
– Physiological dysfunction may be delayed relative to clinical recovery, suggesting that using a ‘buffer zone’ of a graduated return to activity/return to play progression before full return to contact risk may be appropriate
– Preinjury mental health problems and prior concussions appear to be risk factors for persistent symptoms.
– Greater acute and subacute symptoms are a consistent predictor of worse clinical outcome.
– The teenage years might be a particularly vulnerable time for having persistent symptoms—with greater risk for girls than boys.
– Strongest evidence exists for disallowing body checking in youth ice hockey
– Strong recommendations to mandate helmet use in skiing/snowboarding
– Mixed evidence for mouthguard but there may be an overall protective effect
The top 5 key messages from the 5th International Consensus Statement on Concussion in Sport
- McCrory P, Meeuwisse W, Dvořák J, et al. Consensus statement on concussion in sport—the 5thinternational conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017;51:838-847.
- Shields, MD, CCFP, Sport and Exercise Medicine Fellow, University of Ottawa
Advisor: Taryn Taylor, MD, CCFP (SEM), Dip Sport Med
Education and Advocacy Traumatic brain injuries inflict complicated challenges for victims and caregivers and there is a need for political and social progress to improve quality of life.
Brain injuries can be caused by many factors including motor vehicle accidents, falls, sports injuries, physical abuse, and alcohol related incidents. Generally, the public doesn’t realize how widespread brain injuries are or the extensive and potentially devastating effects they can have on physical, cognitive, emotional, and behavioural levels. A traumatic blow to the head can lead to the disruption of brain functioning, resulting in confusion, forgetfulness, headaches with associated symptoms, and behavioural concerns, as well as a range of emotional issues including depression. Although some head injuries may not immediately appear to be serious, many have long-lasting and very detrimental effects.
Aquired Brain Injury (ABI) is an injury to the brain that occurs after birth. There are a variety of injuries that can cause ABI, and knowing what resources are available can be helpful in moving past the injury.
Living with an acquired brain injury
The brain controls everything we do—it’s the computer for our whole being! Imagine how you would feel if you sensed something was wrong with your own brain. A devastating feeling! Now, imagine you just suffered a brain injury. What would you do? Who could you talk to? The number and severity of problems resulting from a brain injury varies from person to person because each individual’s brain injury is different. A widely perceived myth is that a brain injury is simply a type of intellectual disability. People who acquire a brain injury usually retain their intellectual abilities but have difficulty controlling, coordinating and communicating their thoughts and actions.
Can the brain heal from an injury?
The healing brain has intense neuroplasticity. It is able to reshape and rebuild itself in ways we are only beginning to understand. While the initial intensity does gradually slow as healing progresses, it does not stop. With the right help, people with ABI can improve the way their brain functions, and they can often reclaim the portions of their lives that were affected by the injury. Years after brain injury, survivors are still passing incredible milestones.
Introducing Suzanne McKenna
Suzanne McKenna is a trusted and accomplished Acquired Brain Injury (ABI) System Navigator for the Champlain Community Care Access Centre (CCAC). She provides a single point of access for both individuals and caregivers living with an ABI. Suzanne also has first-hand experience as a caregiver for her 26-year old son who has lived for the last eight years with a traumatic brain injury. People living with acquired brain injuries can feel overwhelmed without the proper supports. Suzanne helps them and their caregivers to deal with difficult issues to improve their quality of life. Suzanne shares information about her role and offers hope for those with an ABI.
How can someone with a brain injury get help?
Please call the Champlain CCAC at 613-310-2222 to speak with Suzanne McKenna. You can also browse the ABI resource guide at www.champlainhealthline.ca. This guide brings together all of the ABI service providers, services and organizations available in the Champlain region into one user-friendly resource.
reposted from the Fall 2015 Health Matters magazine
The Acquired Brain Injury (ABI) System Navigator provides a single point of entry for patients and health care teams to access ABI services across the Champlain region.
An acquired brain injury is damage to the brain, which occurs after birth, as a result of a traumatic or non-traumatic event, and is not related to a congenital or degenerative disease. ABI can result in temporary, prolonged or permanent impairments in cognitive, behavioural or physical functions.
As a person with an ABI moves through the recovery process, their health care team will contact the ABI System Navigator who then coordinates referrals with the Champlain ABI Coalition.
The ABI System Navigator identifies opportunities for collaboration among ABI and non-ABI service providers including mental health, addictions, developmentally delayed, geriatrics, corrections, and housing.
How to Request Service
Requests for assistance can be made by the individual themselves, loved ones, or healthcare professionals. To request service, please complete the Champlain ABI Application for Service form and return it as per the instructions on the form.
With the patient’s consent, the information will be shared with the Champlain ABI Coalition Admissions Committee, which reviews the application and matches the person’s needs with the availability of services. Applicants approved for service are notified by the appropriate agency.
Additional ABI Resources
An ABI database is now available on Champlainhealthline.ca. This database is designed to provide information about educational opportunities and services available to people living with an ABI.
An ABI Primary Health Care Resource Guide is also available to be used as a quick reference tool for ABI support services available in the Champlain region (e.g. day programs, transportation, continuing education, support groups, recreational opportunities).
If you have any questions about services and resources available for those living with the effects of an acquired brain injury, please contact:
Suzanne McKenna, Champlain ABI System Navigator
Champlain Community Care Access Centre (CCAC)
Tel: 613-745-5525 ext. 5963