Current Concussion Evaluation and Treatment Approaches

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Why take this course?

This intermediate level online continuing education course is applicable for Physical Therapists, Physical Therapist Assistants, Occupational Therapists, and Athletic Trainers. This is an intermediate Level Occupational Therapy Process: evaluation, intervention.

This evidence-based course provides the clinician with the tools necessary to evaluate and treat the many symptoms associated with the concussion patient. The pathophysiology of a concussion and its associated symptoms is presented from medical, neuropsychological and therapeutic perspectives. Through this team approach, you will learn to identify red flags, develop proper communication skills, and in turn, promote patient compliance throughout the rehabilitation process. This will enhance the patient’s overall ability to understand the process of recovery and the importance of team/family involvement for successful outcomes.

This course is designed for the participant to first review all the videos and written material and then practice the techniques. Please also take time to review the reference articles included. This will help to correlate the presented material to the evidence-based resources.

Details about this Online Continuing Education Course

Elizabeth Georgelos, PT, MS, NCS, presents the essential evaluation and treatment techniques to progress a patient through rehab. Most importantly, you will hear the testimonials of three people who suffered concussions/TBI and their personal journeys through the process. Exposure to their perspectives will enhance your ability to understand what a patient experiences throughout the healing process--a powerful tool when developing appropriate rehab programs for specific individuals.

The clinical evaluation techniques presented in this course provide key information for ruling out the source(s) of symptoms. Elizabeth begins with an oculomotor screening then progresses to common tests utilized within the oculomotor exam in order to rule out convergence, accommodation, VOR deficits, ocular misalignment and static and dynamic acuity issues. Since problem-solving the source of the symptoms can be difficult, Elizabeth demonstrates additional tests to identify joint position sense deficits, BPPV and causes of motion sensitivity. She also demonstrates how to incorporate the use of infrared goggles into your comprehensive examination.

Differential diagnosis can be complicated with concussion-vestibular symptoms. Therefore, we have a certified orthopedic specialist take you through the assessment techniques to rule out cervicogenic origins of symptoms and demonstrate common treatment techniques to address the musculoskeletal dysfunction which may present as a headache or migraine.

Additional tests are demonstrated to identify the underlying cause of symptoms, including the Modified Clinical Test of Sensory Integration on Balance and Dynamic Balance Testing.

Demonstration on the Balance Master provides a great summary of how to assess a patient’s balance abilities and his or her ability to use different sensory systems. Elizabeth will provide information on how to apply this type of testing in the clinical setting even if you do not have access to a Balance Master.

In conclusion, techniques to develop a progressive treatment approach are presented to improve symptoms related to BPPV, oculomotor issues such as gaze stabilization, accommodation deficits and convergence deficits, as well as static and dynamic balance motion sensitivity.

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  • CE Hours: 13 hrs
  • Delivered: Online
  • Instant Online Access, Color 175 Page PDF Manual for Download, 365 days of access, Mobile Ready
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Highlights of this Online Course

PT OT Online continuing education course objectives

Course Objectives

  • Identify the importance of the multidisciplinary rehab team when developing a comprehensive rehab program for successful functional outcomes.
  • Describe the underlying pathophysiology of a concussion, common symptoms and the factors involved with recovery..
  • Develop problem-solving skills to identify the most appropriate assessment tool for differentiating the source of the problem in order to avoid over stimulation and fatigue.
  • Identify common red flags that are associated with a concussion and determine when a referral is needed.
  • Perform a cervical screen to rule out cervicogenic headaches.
  • Discuss common tools utilized among the interdisciplinary team to assess executive functioning abilities.
  • Discuss the importance of mindfulness and sleep patterns with your patients so they have the tools necessary to achieve better functional outcomes.
  • Understand the patient’s perspective on symptoms by listening to specific testimonials and then incorporate this information into a comprehensive plan.
  • Perform a comprehensive oculomotor exam by establishing the patient’s baseline.
  • Perform evidence-based test for convergence and accommodation issues, saccadic eye movements, vestibular-ocular reflex, VOR cancellation and ocular misalignment.
  • Properly perform the motion sensitivity test to determine severity of symptoms with specific movements.
  • Identify when modification of the treatment plan is necessary to avoid overstimulation and regression of gains.
  • Perform specific tests to rule out BPPV as a cause of the symptoms.
  • Determine when it is appropriate to use infrared goggles in your assessment plan.
  • Utilize evidence-based assessments and tools such as: Accommodation Tool, King-Devik, Functional Gait Assessment to establish baselines for treatment.
  • Develop appropriate rehab programs that incorporate the synergistic coordination of multileveled sensory integration.
  • Develop challenging and progressive treatment sessions to improve visual motion sensitivity, dynamic balance, oculomotor control, joint position awareness and endurance.
  • Perform the Modified Test for Sensory Interaction on balance and accurately interpret your findings.
  • Develop tools to help your patient successfully apply rehab activities to real life situations, functional activities and daily tasks.
  • Understand how to perform the six steps within the Sensory Organization Test and accurately interpret the findings to establish a proper treatment progression program.
  • Test and treat for advanced sensory integration and balance deficits.
  • Understand how the Balance Master assists in reaching overall goals and how to apply the concepts of the Balance Master into your treatment approach if it is not accessible in your clinic.
  • Be an advocate for post-concussion patients who can’t advocate for themselves.

Introduction to the Certified Neurological Clinical Specialist

Introduction to the Certified Neurological Clinical Specialist
  • Educators background and clinical experience
  • What is a vestibular specialist?

What is a Concussion? How do you Effectively Approach the Evaluation and Treatment Plan?

What is a Concussion
  • What is a concussion and how is it diagnosed?
  • Determining the severity of a concussion determined?
  • Pathophysiology of a concussion.
  • Physiological systems involved with a concussion.

Interview : Board Certified Concussion Specialist MD

Board Certified Concussion Specialist MD
  • Importance of a unified team approach when treating a patient with a concussion
  • Common problems associated with a concussion
  • Importance of a cognitive screening
  • The use of Computerized Neuropsychological Testing
  • Neurometabolic dysfunction
  • Red flags
  • Research-biomarkers

Neuropsychology and its Contribution to the Treatment Team

Neuropsychology and its Contribution to the Treatment Team
  • The role of the Neuropsychologist
  • Specific tests performed by a Neuropsychologist to establish barriers, strengths and weaknesses
  • Mindfulness meditation

Therapy Overview for Patients with Concussions

Therapy Overview for Patients with Concussions
  • Components of the evaluation
  • Balance
  • Motor control
  • Gaze stabilization
  • Convergence issues
  • Orthopedic considerations
  • Vestibular involvement
  • Cognitive deficits
  • Oculomotor and visual deficits
  • Prioritizing your approach

Case Presentation: Young Athletic Patient with a Concussion

Case Presentation:  Young Athletic Patient with a Concussion
  • Rehab summary
  • Case study- the journey to a proper diagnosis
  • Establish an understanding of the post concussive journey from a patient’s perspective

Orthopedic Screening and Treatment for Cervicogenic Headaches

Orthopedic Screening and Treatment for Cervicogenic Headaches
  • Ruling out underlying orthopedic issues
  • Performing an upper quarter screen
  • Joint mobilization-cervical-thoracic
  • Cervical neck flexor endurance test
  • Checking for compensatory motion
  • Joint mobilizations-treatment

Oculomotor Exam

Oculomotor Exam
  • Establish a baseline
  • Specific tests
  • Vestibulo-ocular reflex-VOR
  • Head thrust test
  • VOR cancellation
  • Dynamic visual Acuity
  • Ocular misalignment
  • Conversion test

Motion Sensitivity Test

Motion Sensitivity Test
  • Establishing a baseline
  • Motion Sensitivity Quotient test
  • King-Devick Test
  • What is considered a positive test for BPPV?
  • Ruling Out BPPV
  • Post traumatic BPPV
  • Dix hallpike test
  • Roll test

Testing VOR with Goggles

Testing VOR with Goggles
  • Testing the vestibular system with visual fixation removed
  • Gaze evoked nystagmus
  • Shake Test

Dynamic Balance Testing

Dynamic Balance Testing
  • Functional Gait Assessment
  • Tandem walking-easy to challenging

BPPV Treatments

BPPV Treatments
  • Horizontal BPPV
  • BBQ Roll
  • Epley Maneuver

Treatments for : Gaze Stabilization; Convergence Insufficiency; Oculomotor Issues; dynamic Balance; Visual Motion Sensitivity

Gaze Stabilization-Convergence Insufficiency
  • Variety of treatment activities and progression of activities to increase function
  • Gaze stabilization exercises
  • VOR x 2
  • Convergence training activities
  • Brock String and modifications
  • Oculomotor activities
  • Activities to improve tracking
  • Working on saccadic eye movement
  • Dynamic balance activities
  • Optokinetic stimulation

Case Presentation: Actual Patient Story-Post Concussion

Case Presentation: Actual Middle age Patient with Concussion
  • Rehab summary
  • Case study- the journey to a proper diagnosis
  • Most challenging symptoms
  • Establish an understanding of the post concussive journey from a patient’s perspective
  • Test to determine joint position sense in the neck
  • Test to determine static balance
  • Modified CTSIB
  • Assessing for the Ability to Converge
  • Establishing a baseline

Case Presentation: Actual Patient Story-Post TBI

Case Presentation: ACtual Patient with Traumatic Brain Injury
  • Rehab summary
  • Case study- the journey to a proper diagnosis Most challenging symptoms Establish an understanding of the post concussive journey from a patient’s perspective

Balance Assessment

Balance Assessment
  • Modified Clinical Test of Sensory Integration on Balance
  • Advanced Sensory Integration
  • Sensory Organization Test-six conditions demonstrated on Balance Master and modified for when a Balance master is not available

Course Test - Evaluate your knowledge

Evaluate your understanding of the online continuing education course material
  • Use the Healthclick proprietary online education system which provides the online student with:
    • Worldwide access to high definition video, anatomical animations and images, and written information
    • The highest quality film in the industry, you can see the difference!
    • Stop and resume within a course, the Healthclick system will optimize your course based on your device, connection and remembers where you left off.
    • Real-time course updates. We are always adding to each courses, updating content, adding animations, these are not static courses!
  • Evaluate your knowledge with the course test on any device.
  • Print your state course certificate for CE credit.
  • Take the online test as many times as need in order to achieve a 70 % or greater score.