06:32am Thursday 17 October 2019

Concussion guidelines to help adults manage persistent symptoms, resume life

Guidelines for Concussion/Mild Traumatic Brain Injury and Persistent Symptoms (2nd Edition) uses significantly updated evidence to support health-care providers who are helping their adult patients return to normal daily life.

The guidelines were developed by a committee that included Dr. Donna Ouchterlony, head of the Head Injury Clinic at St. Michael’s Hospital. “Concussion/mild traumatic brain injury is a major health problem due to the high incidence and persistent chronic disability and symptoms,” Dr. Ouchterlony said. “These guidelines will help health care professionals bring the best care to everyone in Ontario.”

Every year in Ontario an estimated 80,000 people suffer a concussion, or mild traumatic brain injury. Of those, as many as 16,000 can experience lingering, troublesome symptoms for more than three months. Nearly a decade later, this incidence rate is widely thought to be considerably higher.

“Concussion is commonly thought of as a sports injury,” said Dr. Shawn Marshall, lead author on the guidelines and a physician at The Ottawa Hospital Rehabilitation Centre.

“But the reality is that many concussions, or mild traumatic brain injuries, come from mishaps of daily living, such as slipping on the ice while walking the dog, falling down the stairs at home, or being in a car crash. There are currently good sports guidelines about how to return to play. Our guidelines take a broader view. We want to help people return to their lives.”

Dr. Marshall said that resting the brain is the first priority and helps the vast majority of concussion patients. But when symptoms last months, emerging research pulled together in the new guidelines shows that resting for too long can become detrimental to well-being. People lose physical fitness and they can become isolated and depressed.

“Persistent symptoms need to be treated more actively to help people resume daily life,” Dr. Marshall said.

Dr. Marshall said the guidelines were needed because not everyone is an expert on mild traumatic brain injury.

“There are many family doctors and other providers who want, or need, to become more knowledgeable about comprehensive management of concussion,” he said. “These guidelines help them navigate the recent and overwhelming explosion of concussion research.”

Designed for health-care providers to manage concussion/mTBI in adults over 18, the guidelines include ways for physicians and other clinicians to objectively evaluate, monitor and manage symptoms. They also provide concrete strategies and tools for all types of health-care providers.

The guidelines are free and available at www.onf.org and www.ConcussionsOntario.org.

About St. Michael’s Hospital

St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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