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Concussion: Common Findings in the Physical Therapy Evaluation

presented by Anne Mucha and Susan Whitney

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:
Concussion often results in a multitude of issues, including symptoms, deficits in cognitive function and impairments in the vestibular and visual systems. Effective management requires that these various deficits areas are properly assessed and treated. Physical therapists involved in the management of persons following concussion should be able to screen for vestibular, ocular and cervical impairment, regardless of area of practice. This course will review basic screening techniques for cervical, vestibular and ocular pathology following concussion, including exposure and instruction in performing a new screening exam (the Vestibular/Ocular Motor Screen). This course will discuss common vestibular and visual system impairment and symptom presentation associated with these impairments. The influence of vestibular and visual findings on recovery after concussion and a case study will be discussed.

Meet Your Instructors

Anne Mucha, DPT, MS, NCS

Anne Mucha is the Coordinator of Vestibular Rehabilitation for the University of Pittsburgh Medical Center Sports Concussion Program and Centers for Rehab Services. She is a board certified clinical specialist in Neurologic Physical Therapy with advanced certification in vestibular rehabilitation. With over 20 years in treating individuals with neurologic conditions, she is also actively involved…

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Susan Whitney, DPT, PhD, NCS, ATC, FAPTA

Susan L. Whitney, DPT, PhD, NCS, ATC, FAPTA received her PhD in motor development/motor learning from the University of Pittsburgh, her professional physical therapy education from Temple University in Philadelphia, PA, and her DPT from MGH Institute of the Health Sciences. Currently, she is a professor in physical therapy in the School of Health and…

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Chapters & Learning Objectives

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1. Common Vestibular and Visual Findings in Concussion

In this chapter, Dr. Whitney and Dr. Mucha describe common vestibular and visual system abnormalities following concussion. The participant will learn how to identify how vestibular and visual system abnormalities influence recovery following concussion

2. Clinical Vestibular Testing

The participant will learn how to assess the positives and negatives of clinic vestibular testing for persons with concussion. Dr. Whitney and Dr. Mucha describe the value of the head impulse test. They demonstrate how to generate at least 3 clinical balance tests that can be used for a person post-concussion. The participant will learn how to identify the clinical significance of abnormal gaze holding during the examination of the person post-concussion.

3. Lab Vestibular Testing

Dr. Whitney and Dr. Mucha assess the positives and negatives of lab vestibular testing for persons with concussion. They describe the value of caloric and rotational chair testing. The participant will learn how to interpret the findings of computerized dynamic posturography.

4. Balance Assessment following Concussion

In this chapter, Dr. Whitney and Dr. Mucha will teach the participant how to utilize and apply the findings from the computerized dynamic posturography results to the design of an exercise program for a person post-concussion. They discuss how to judge which test and measure is most applicable for a person post-concussion. The participant will learn to analyze the benefits and limitations of balance testing in persons post-concussion.

5. Recognizing BPPV in the Person Post-Concussion

The participant will learn how to recognize the signs and symptoms of BPPV and how to screen for it. They will be able to perform the DixHallpike and Roll Tests and provide common interventions for posterior and horizontal canal BPPV.

6. Case Study: 18 Year-old Hockey Player

In this chapter, Dr. Whitney and Dr. Mucha discuss the case of a 18 year-old defensive player in the Major Junior Hockey League. He presents with a concussion with 1-2 sec LOC, brief retrograde amnesia, 20 min post-traumatic amnesia, and a negative CT scan. Dr. Whitney and Dr. Mucha discuss the player's initial symptoms, medical history and ongoing complaints to better diagnose and treat the patient's concussion.

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