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Concussion Testing 

Concussion Testing 

Bullet Point Summary -

  • Concussions result from head contact or shaking, causing temporary brain dysfunction with various symptoms.
  • Common symptoms include headaches, dizziness, sensitivity to light or noise, and cognitive and emotional changes.
  • Concussion testing methods include physical examinations, neurocognitive tests (such as ImPACT and SCAT), and imaging tests.

Concussions are a common yet often underestimated injury that can have serious consequences if not properly diagnosed and managed. Despite their frequency, concussions are commonly overlooked or downplayed. This can have severe implications, as some concussions result in a wide range of symptoms, including headaches, dizziness, cognitive impairments, mood changes, and even long-term neurological complications. Fortunately, The awareness surrounding concussions and their potential long-term effects has increased significantly. 

One crucial aspect of concussion management is accurate and reliable concussion testing. Early detection and accurate diagnosis through various assessment methods are essential for ensuring appropriate management, preventing long-term complications, and facilitating a safe return to sports and other activities. 

Keep reading for an in-depth discussion on concussions, the signs and symptoms to look out for, and mainstay concussion testing methods. Revive Spine and Sport Physiotherapy offers concussion assessment and management in Edmonton, AB.

Understanding Concussions 

A concussion is a mild traumatic brain injury caused by direct contact to the head or a violent shaking of the body, which leads to sudden unwanted movement of the brain within the skull. This impact can lead to temporary dysfunction and disturbance of normal brain function.

Various situations can result in a concussion, from sports-related collisions to falls and accidents. Concussions are common in sports such as football, soccer, hockey, and basketball due to the physical nature and speed of the game. However, concussions are not exclusive to sports as they also commonly occur in recreational activities, workplace incidents, motor vehicle accidents, and even slips and falls at home. 

The broad range of situations in which concussions can occur emphasizes the need for widespread awareness, prevention strategies, and appropriate concussion testing protocols across different settings. Whether it is a professional athlete on the field, a construction worker at a job site, or a child playing at the playground, the potential for concussions exists, highlighting the importance of recognizing the signs and symptoms of a concussion for prompt diagnosis and appropriate management.

The Signs And Symptoms Of A Concussion

Signs and symptoms of a concussion can vary from person to person and may manifest immediately after the injury or take hours or even days to appear. It's important to note that patients may experience different severity and combinations of symptoms, and not all symptoms may be present in every case. With that in mind, here are some common signs and symptoms of a concussion:

Physical Symptoms:

  • Headache or pressure in the head
  • Dizziness or balance problems
  • Nausea or vomiting
  • Sensitivity to light or noise
  • Fatigue or drowsiness
  • Blurred vision or difficulty focusing
  • Changes in appetite or eating patterns

Cognitive Symptoms:

  • Feeling mentally foggy or slowed down
  • Difficulty concentrating or remembering new information
  • Confusion or feeling disoriented
  • Difficulty organizing thoughts or finding words
  • Social withdrawal or isolation
  • Increased sensitivity to environmental stimuli (e.g., noise, light)

Emotional Symptoms:

  • Irritability or mood swings
  • Anxiety or nervousness
  • Sadness or depression
  • Increased emotional sensitivity
  • Changes in sleep patterns (insomnia or excessive sleepiness)
  • Agitation or restlessness

For any suspected concussion, especially if the symptoms are severe or unexplained, it's essential to seek medical attention and consult a healthcare professional trained in concussion management. They can conduct a thorough evaluation and determine the most appropriate course of action for diagnosis, treatment, and recovery. Additionally, it's crucial to rest and avoid activities that may worsen symptoms until receiving proper medical guidance to prevent further injury.

The Importance Of Concussion Testing

Healthcare professionals and sports organizations have recognized the need for proper and thorough concussion testing protocols and guidelines to protect athletes and the community. Concussion tests serve multiple purposes, including: 

  • Early Detection And Proper Diagnosis: Early identification of concussions allows for appropriate assessment and management, reducing the risk of further injury or complications. It also enables healthcare professionals to develop individualized treatment plans tailored to the patient's needs.
  • Preventing Long-Term Complications: Undiagnosed or untreated concussions can lead to long-term cognitive, emotional, and physical impairments. Timely identification of concussions is important for getting the necessary care, such as rest and gradual return to activity, which are essential for minimizing the risk of further injury or complications.
  • Safe Return To Sport And Other Activities: Concussion tests are essential for determining when it is safe for an individual to return to sports or other physical activities. Through a combination of physical examinations, neurocognitive assessments, and symptom evaluations, healthcare professionals can assess a patient’s readiness to resume normal activity. Gradual reintroduction, guided by test results, reduces the chances of re-injury and ensures optimal recovery.

Concussion Testing Methods

Concussions require accurate and timely diagnosis to ensure appropriate management and prevent potential complications. So, how do doctors assess for a concussion? The following are some of the mainstay ways for testing for a concussion: 

Physical Examination By A Healthcare Professional

A comprehensive physical assessment is the first step in concussion testing. Trained health professionals, such as doctors or sports physiotherapists, use specific tests to identify the visible signs of a concussion. During a physical examination, healthcare professionals may employ techniques such as neurological examinations, balance tests, and eye movement assessments to help determine the presence of a concussion. These tests assess reflexes, coordination, muscle strength, and the integrity of the visual system, all of which can provide valuable information about the head injury.

Neurocognitive Testing

As part of the assessment, the health professional may use neurocognitive tests to evaluate cognitive functions that may be affected during a concussion, such as memory, attention, and reaction time. These tests provide insights into the individual's cognitive abilities and help healthcare professionals diagnose and monitor concussions. Two commonly used tests in this category are the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and the Sport Concussion Assessment Tool (SCAT). 

ImPACT Concussion Test

ImPACT is a computerized neurocognitive test widely utilized in sports medicine. It assesses multiple cognitive factors, including attention, memory, and processing speeds, and establishes a baseline for comparison during recovery. In the event of a suspected concussion, the test can be administered again to compare the results with the baseline, aiding healthcare professionals in diagnosing and managing concussions.

SCAT Concussion Test

SCAT, on the other hand, is a standardized baseline concussion test used to evaluate concussions in athletes. It provides a structured approach that incorporates physical and cognitive examination with symptom assessment to determine the severity of the injury. For example, the patient may be asked to perform tasks such as remembering a list of words or numbers, counting backwards, and completing reaction time exercises. These tests help evaluate cognitive impairments that may be associated with the concussion.

Imaging Tests

Doctors may also use imaging technologies, such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans, to provide detailed images of the brain and detect any structural abnormalities after a potential concussion. These tests can help healthcare professionals visualize the brain and identify any visible damage or bleeding that may require immediate medical attention. They can also be valuable in ruling out other possible head injuries or complications associated with concussions. 

Online Concussion Tests

There are a wide variety of self-administered online concussion tests available now-a-days, such as the 1-minute concussion test. Although at-home concussion tests should not be used as a standalone assessment or treatment for a concussion, these concussion tests can be completed online as a quick assessment. The concussion test questions are usually basic, used to detect symptoms, gather information, and act as a prompt to see a health professional. 

While these self-concussions tests may offer convenience and initial insights, they should not replace a comprehensive evaluation by a healthcare professional. If there is a suspicion of a concussion, it is always recommended to seek medical attention for proper assessment, diagnosis, and early treatment.

Limitations Of Concussion Testing

While concussion testing is essential, it is not without limitations:

  • Subjectivity And Variability In Results: Some tests rely on self-reported symptoms, making them susceptible to individual interpretation and biases. The reliability of certain assessments may vary due to factors such as fatigue, motivation, or pre-existing conditions.
  • Lack Of Standardized Protocols: Consistency in concussion testing protocols across different healthcare settings is critical to consistently detecting concussions and protecting athletes. Lack of standardization can lead to inconsistencies in the interpretation of test results and hinder accurate diagnoses.
  • False Negatives And Positives: Concussion testing is not foolproof, and there is a risk of both false negatives and false positives. False negatives occur when a concussion is present but goes undetected by the tests, potentially leading to inadequate management. False positives, on the other hand, can occur when test results indicate a concussion that may not actually be present, resulting in unnecessary restrictions or interventions.

The Future Of Concussion Management

It is crucial to recognize that concussions are not mere inconveniences or minor bumps on the head. In fact, they are significant injuries that require careful assessment and attention in order to initiate proper medical intervention. 

Proper concussion diagnosis and management are essential to ensure the safety, well-being, and optimal recovery of those affected. Effective testing and treatment strategies can help mitigate the potential long-term consequences and provide the necessary support to regain their health and quality of life.

For concussion rehab in Edmonton, seek the expertise of our Edmonton physiotherapists at Revive Spine and Sport Physiotherapy. 

References 

Physiopedia. Assessment and Management of Concussion. Available from: https://www.physio-pedia.com/Assessment_and_Management_of_Concussion 

Health Direct. Concussion. Available from: https://www.healthdirect.gov.au/concussion#:~:text=Concussion%20is%20a%20mild%20brain,and%20vision%20or%20speech%20problems

Concussion in Sport Australia. Assessment Of Concussion. Available from: https://www.concussioninsport.gov.au/medical_practitioners/link_listing/assessment_of_concussion 

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