Neuro OT - Combating the effects of concussion
Neuro OTs can help combat the creeping effects of concussion that take their toll on everyday life long after the injury occurred.
Dubbed in recent times ‘a serious public health epidemic’ , concussion accounts for around one million A&E visits every year, with common causes including traffic and sports accidents, falls and assaults.
Symptoms of concussion - which is also termed mild or minor traumatic brain injury (mTBI) - usually resolve within a few weeks.
But as many as one in five people may find these symptoms continuing for longer and impacting on their participation in school, work and leisure activities as a result.
Symptoms include:
- Loss of consciousness.
- Inability to wake or drowsiness.
- Confusion.
- Dizziness
- Problems speaking or being understood.
- Noise/light sensitivity.
- Blurred/double vision.
- Tingling or weakness in an arm or leg.
- Collapse or seizures (twitching, shaking).
- A worsening headache.
- Vomiting.
- Post-traumatic amnesia (memory loss).
- Restlessness
However, recent evidence shows some people continue to experience visual, vestibular (balance), cognitive, emotional and sleep disturbances long after the concussion.
Known as post-concussion syndrome, it is here where Neuro OTs can help.
Bed rest is not best!
Historically, the response to concussion has been bed rest until the symptoms ease, but, with emerging medical evidence, the recommended treatment has changed.
Now ‘a graded return to activity’ is prescribed in which activities are limited or stopped altogether if they start to aggravate symptoms.
But it is a treatment that not only requires independent monitoring and enhanced self-awareness but may also involve the need for modifications of the activity or environment; a role encompassing the expertise of a Neuro OT.
A balanced approach to activity that carefully considers the interaction between person, task, and environment is congruent with the foundations of the profession of occupational therapy 
There are no current guidelines in place for OTs working with concussion casualties. However, a new report by New York researchers could provide a blueprint.
‘An Occupation-Based Approach to Management of Concussion’ proposes a framework that enables OTs to assess concussion casualties and provide client-centred therapy in response.
The process begins with a comprehensive occupational therapy assessment post-concussion to discover:
- Areas of occupation affected by the symptoms.
- Current and pre-injury daily routine.
- Other factors associated with the symptoms.
- Visual skills.
- Balance.
- Coordination.
- Sensory processing.
- The client’s values, roles and interests.
- The client’s desired outcomes.
The findings from these assessments can reveal links between post-concussion symptoms and an individual’s difficulties and engagement in meaningful occupations.
They also provide the foundations for an Occupational Therapist to develop a treatment plan that is unique to the client in meeting these occupation-based needs.