Standard Medical Practices for Traumatic Brain Injury and Concussion

Standard Medical Practices for Traumatic Brain Injury and Concussion

Whether it be related to a concussion, repeated hits to the head, or exposure to toxic chemicals, medical professionals rely on standard practices when making treatment decisions. These treatments often include physical and cognitive rest, vision therapy, physical therapy and/or medications.

Physical and Cognitive Rest

For years, patients have been prescribed physical and cognitive rest until the symptoms associated with their TBI or concussion go away. This treatment has been based on two assumptions: (1) rest decreases the chance of reinjury during the period of recovery when the brain is most vulnerable, and (2) physical and cognitive activity can increase symptoms and impairments post-injury, thus potential prolonging recovery time. Because of these assumptions, doctors have even recommended that additional therapies, such as physical therapy or vision therapy, be postponed until rest has alleviated all injury-related symptoms.

Physical Therapy

Doctors often recommend low-levels of physical exertion under the watchful eye of a trained physical therapist as a means of treating TBI and concussion. These activities can include coordination activities, aerobic exercise, and vestibular therapy (i.e., exercises that help with inner-ear issues, such as vertigo or dizziness). Moreover, physical therapy is especially important for athletes looking to perform at their pre-injury level of ability. Although there is ample research supporting the active treatment of concussion via physical therapy, there are still some doctors who wait to prescribe this treatment until their patients rest until they are symptom-free.

Vision Therapy

Vision therapy is another common treatment that doctors recommend for patients following a TBI or concussion. Because these injuries can affect a patient’s ability to read, concentrate, and track objects with their eyes, the patient may have exceptional difficulty with work or school-related tasks. In addition, it is crucial for athletes to regain their hand-eye coordination prior to returning to their sport. Vision therapy, then, is frequently prescribed by doctors when treating patients with TBI or concussion as a means of helping patients regain their pre-injury levels of functioning and ability.

Medication

Although the prescription of medications for TBI and concussion is highly dependent on individual circumstances, some doctors prescribe medication following TBI and concussion as a means of managing symptoms. For example, some patients may be prescribed medications to help with migraines while others might receive prescriptions to help with concentration or fatigue. Because TBI and concussion are associated with changes in mood (e.g., depression, anxiety, or frustration tolerance), it is not uncommon for these patients to be referred to a psychiatrist for antidepressants, anti-anxiety medications, stimulants, or sedatives.

Other recent treatment approaches include biofeedback, acupuncture, hyperbaric oxygen therapy, cognitive behavioral therapy, joint manipulation and injections; however, rest, physical therapy, vision therapy, and medication remain the four most common practices used by doctors when treating patients with TBI or concussion. These treatments may be used in isolation, but best practices indicate that treatment should be multidisciplinary. Therefore, it is common that doctors rely on a combination of treatments when working with patients who have TBI or concussion.

Despite the use of multiple treatments, there are a number of patients that experience limited or no relief from these treatments, even after exhausting all standard medical practices related to TBI and concussion.

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