Musculoskeletal Medicine and PainREVIEW

Concussion Evaluation and Management: An Osteopathic Perspective

Hallie Zwibel, DO; Adena Leder, DO; Sheldon Yao, DO; and Christina Finn, OTR/L
Notes and Affiliations
Notes and Affiliations

Received: June 11, 2018

Accepted: July 10, 2018

Published: September 17, 2018

J Osteopath Med; 118(10): 655-661

Concussions have been increasingly reported over the past decade, but the reported incidence likely minimizes the actual numbers of people affected. Associated symptoms include emotional, somatic, and cognitive complaints, which may be prolonged in patients with certain risk factors. Neurologic examination is necessary to exclude upper motor neuron lesions and thus the need for brain imaging. Cervical conditions are often found concurrently with head injury and displays a similar presentation to concussions. Therefore, determining symptom origin can be problematic. Neuropsychological, oculomotor, and balance evaluations expose specific deficits that can be successfully managed with rehabilitation. Osteopathic assessment of the cranium, spine, sacrum, and thorax for somatic dysfunctions allows for prudent interventions. Patients involved in sports may begin an established graduated return-to-play protocol once cleared by their physician. Concurrently, a parallel return-to-learn program, with applicable academic accommodations, is recommended.

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