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Identifying and treating a concussion is key to recovery

Knowing that a child has a concussion is just the first step in treating it.

Colin Ellis, a physical therapist with Lehigh Valley Health Network Outpatient Neurologic Rehabilitation, talked about rehabilitation treatments during an online information session hosted by LVHN titled “Because They’re Kids: Fall Sports and Concussions.” Dr. Duy Tran, a pediatrician in emergency medicine at LVHN, spoke about how to prevent and identify concussions.

Ellis said that patients who get treatment soon after a concussive injury have better outcomes compared to those treated years later.

“We see patients that are years post mild-traumatic brain injury really struggling,” he said. “The rehab and the recovery timeline and the prognosis become more complicated the longer after the injury.”

There are a variety of therapies available to people with head injuries that include physical therapy, occupational, speech, vision and psychological therapies. Therapy usually begins about 24 to 48 hours after a person has had a chance to rest both physically and cognitively from the concussion.

Physical therapy involves starting with some limited physical activity, and progresses to light aerobic activity, and sport-specific activity. From there, it increases to noncontact training drills, then to full contact drills with the goal of returning to playing the sport. If the athlete experiences any symptoms of the concussion during therapy, then that level is stopped and the person goes back to the previous level, he said.

Therapists assess key domains: the cervical spine, oculomotor system (eyes), vestibular system (balance and gait), and a graded return to exertion based on standardized protocols.

Then there is occupational therapy. It is provided if there are problems with the person’s reaction time, cognitive function, attention and memory, visual processing speed, and visual motor control.

The goal is to help the person to be able to return to their job or school work at a level similar to their abilities before the accident.

Speech therapy helps people when the concussion causes problems with speaking, memory, communication and word-finding.

Vision therapy helps when there is loss of visual clarity, headaches after physical and occupational therapies, or problems tolerating work or school environments.

And psychological therapy helps people who are experiencing anxiety, depression, and even post-traumatic stress disorder.

“We don’t want to rush this process,” Ellis said. If a person goes back to quickly and gets injured a second or third time, “it does have a cumulative effect. We’re talking long-term disability.”

If a person thinks they or their child has had a concussion, they should go to their primary care physician or go to the emergency room. If the injury occurred some time ago or the symptoms have lasted longer than one day after the injury, they may want to contact: LVPG Concussion and Head Trauma Program for an evaluation. The program can be reached at 484-862-3001. The office is located at 707 Hamilton St., Suite 400, Allentown.