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The ever-changing world of concussion rehabilitation

Concussion Rehabilitation Research

A recent article in JAMA (Journal of the American Medical Association) suggests that physical activity following concussion (in youth) is better than rest.

The study itself examined symptoms for PPCS (persistent post concussion syndrome) a month after the concussion and found that the children who had some physical activity within seven days had fewer symptoms than those who had no physical activity. For those of us who have worked with brain injury and concussion for many years this would seem to challenge current recommendations that kids have no symptoms before they return to play.

While this is a useful research tool that researchers and people like myself will look at, a closer examination of the study shows that we still don’t know what brings a reduction to some, but not to others. In some ways it supports the common sense view that one should start slow on the road to recovery. What it should not be taken to mean is that a return to “full contact” without medical clearance is in any way a good idea.

What is encouraging is to know that concussions and traumatic brain injuries are increasingly studied and of interest to researchers, which leads to hope that over time better and better diagnosis and treatment will follow.

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U.S. Proposal for Brain Research Echoes International Call to Reduce the Burden of TBI

Brain scan imagesLast week, President Obama called for $110 million to fund a brain-mapping study, akin to the human genome project. The President said he will include the funding for the “Brain Research through Advancing Innovative Neurotechnologies” (BRAIN) Initiative, in his 2014 budget. Already underway at the National Institutes of Health, it’s hoped that the BRAIN Initiative will eventually yield methods of treating, preventing and curing traumatic brain injury as well as disorders like Alzheimer’s, schizophrenia, autism and epilepsy.

For traumatic brain injury this initiative has the potential to:

a) Advance our knowledge of the mechanisms of brain injury and recovery, and;

b) Help develop better diagnostic tools and treatments for brain injury.

This is one of several key international investments into traumatic brain injury research. The Canadian Institutes for Health Research (CIHR), in collaboration with the European Commission (EC) and the National Institutes of Health (NIH), has set up the International Initiative for Traumatic Brain Injury Research (InTBIR). Established in 2011, this initiative aims to advance clinical traumatic brain injury research, treatment and care in order to “improve outcomes and lessen the global burden of traumatic brain injury by 2020.”

TBI is the leading cause of disability in individuals under the age of 45. The annual incidence of TBI is 500 per 100,000 people in North America and Europe and is steadily increasing due to an increased number of motor vehicle accidents, particularly in low- and middle- income countries. The World Health Organization (WHO) predicts that deaths from road traffic incidents (primarily due to TBI) will double between 2000 and 2020 and TBI will rise to the third leading cause of global mortality and disability by 2020 (WHO, 2009).

Not only does TBI have devastating effects on survivors and their loved ones, but also results in high socio-economic costs to society. As a result TBI has become one of the priorities in the national research agendas of many countries.