Multidisciplinary Concussion Management: A Model for Outpatient Concussion Management in the Acute and Post-Acute...

Area of Science:

• Neurology
• Sports Medicine
• Adolescent Health

Background:

• Concussion management requires a multidisciplinary approach for adolescents with persistent symptoms.
• Acute and post-acute care settings present unique challenges in concussion recovery.
• Adolescent concussion recovery can be influenced by factors beyond the initial injury.

Purpose of the Study:

• To outline a model for multidisciplinary concussion management in adolescents.
• To evaluate management strategies in acute and post-acute concussion care.
• To assess the efficacy of a subsymptom threshold exercise program for persistent concussion symptoms.

Main Methods:

• A pilot randomized controlled trial was conducted within a large health system.
• Participants included adolescents aged 14-18 with concussion symptoms persisting beyond 4 weeks.
• The study compared a subsymptom threshold exercise program with standard-of-care treatment.

Main Results:

• Overall, 60% symptom improvement was observed across groups.
• The exercise intervention demonstrated a significant effect on symptom reduction, particularly after accounting for depression.
• No significant difference in treatment response was found between sports-related and non-sports-related concussion groups.

Conclusions:

• Subthreshold exercise intervention is effective for reducing persistent concussion symptoms in adolescents.
• Multidisciplinary management programs, even with standard care, support meaningful recovery.
• Targeted interventions for depression are essential for optimizing recovery from concussion.