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Persisting Symptoms After Concussion: Managing Chronic Cases

presented by Anne Mucha, DPT, MS, NCS

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Disclosure Statement:

Financial:

Dr. Whitney is a consultant for three Department of Defense grants related to concussion with IAI, inc. She also teaches a continuing education course with Michael Schubert, PT, PhD.

Dr. Mucha is a provider of continuing education courses for APTA and other entities.

Nonfinancial:

Dr. Whitney is vice president of the International Neurological Physiotherapy Group of WCPT.

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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Video Runtime: 89 Minutes, Learning Assessments: 36 Minutes

Management of individuals with chronic disability following mild TBI is particularly challenging. Currently, there is minimal guidance available to physical and occupational therapists on how to treat patients with persisting symptoms after a concussion. This course will help therapists treating individuals with chronic disability to achieve better outcomes using a biopsychosocial model. We discuss in detail how chronic concussion cases may benefit from different management strategies than those for acute and subacute injury. We conclude this course by interviewing a woman with persisting symptoms post concussion and discussing her perspective on key components of care that led to her successful treatment. This course is designed for physical and occupational therapists who treat persons with concussion/mild TBI across all healthcare settings.

Meet Your Instructor

Anne Mucha, DPT, MS, NCS

Anne Mucha is the coordinator of vestibular rehabilitation for the University of Pittsburgh Medical Center Sports Medicine 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 more than 20 years of experience treating individuals with neurologic conditions, she is also…

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Chapters & Learning Objectives

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1. Postconcussion Syndrome: What Is It, and Who’s at Risk?

This chapter helps therapists to understand factors that define and contribute to postconcussion syndrome. A case of a 47-year-old female who had a concussion due to a motor vehicle collision five months prior is used to illustrate many of the biophysical factors that negatively impact her ability to recover from her injury.

2. Management of Chronic Concussion: Concepts for Therapists

Many concepts for treating persons with persisting symptoms post concussion are presented, promoting the biopsychosocial model of care. Strategies such as positive messaging and using cognitive behavioral therapy principles are emphasized throughout case examples of a 53-year-old female and a 19-year-old soccer player who are both experiencing chronic symptoms and disability after concussions.

3. Complex Postconcussion Case Discussion

A 44-year-old male recreational hockey player presented five years after sustaining a concussion. At the start of care, he was only able to work ten hours a week and was unable to participate in family activities. We demonstrate how using cognitive behavioral techniques and a team approach led to a full recovery.

4. Postconcussion Syndrome From the Patient Perspective

A woman who was experiencing significant disability for five months following a concussion talks with Dr. Mucha about her rehab journey and how she was able to return to full-time work and parenting of two young children. She describes how early treatments and advice actually hindered recovery, and highlights what was most helpful in her rehabilitation process.

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