Discussing Concussion Recovery, this article aims to critically review the evidence for long-term and active recovery from concussion, including PCS and symptomatic recovery.
Recent Studies
Emerging data identify a relationship between autonomic, neurophysiological dysfunction and concussion pathophysiology. Studies show that despite lessened TBI, patients with a concussion may still display neurophysiologic changes that may impair their ability to engage in physical activity. Patients with concussions can be classified into three categories: sub-concussion, concussion/following/following, and non-concussion.
Sub-concussion Recovery
Concussion Recovery typically follows the initial phases of post-concussion syndrome. Symptoms include persistent headaches, insomnia, lethargy, irritability, anxiety, panic attacks, and psychological disturbances. In this phase, most patients’ cognition and psychological processes are still intact, but their motor skills are impaired. Physical functioning is still below average, but the patient’s level of awareness has been restored to that of a normal person.
Following Phase
The second recovery phase occurs one week after the original concussion. Most symptoms disappear during this phase but may reappear weeks later. For some, symptoms worsen with time. This is known as the rebound effect of an injury. Unfortunately, because symptoms can persist for weeks and even months, returning to previous activity levels is nearly impossible. For others, symptoms subside in time, and physical activity resumes slowly over time.
Recurrent Symptoms
The third recovery phase consists of recurrent symptoms that develop over time with little to no residual time to complete the rehabilitation process. These include loss of balance, coordination, concentration, memory, and attention span. These symptoms may become so acute that patients are unable to continue normal daily activities. While physical activity is slow in its onset following a concussion, many individuals report progress after several months of rehabilitation and symptom reduction.
Checking the Condition
When evaluating a concussion patient, the first step is assessing the clinical picture using a standard screening tool known as the ARI. The screening tool is used to measure the patient’s cognitive and physical performance at the injury time. It is based on the specific symptoms that were present at the time of the injury and any behaviors that can be attributed to the trauma (i.e. if there is any alcohol or drug use by the victim). If the symptoms are severe enough to rule out the presence of a more serious underlying disorder, an assessment by a physician and a thorough neurological examination are conducted to rule out any more serious issues.
With early and proper rehabilitation following a concussion, the risk of having long-term negative consequences decreases. Unfortunately, many athletes choose to ignore their injuries and wait for the “real” healing. The result can be a compromised ability to function in society due to depression and anxiety. This is why it is important to immediately address the acute symptomatic phase of recovery following a traumatic brain injury.