From valuable baseline testing, to comprehensive post-concussion assessment and ongoing objective monitoring, Alberta Balance Centre can help take any post-concussion care plan to the next level
The Current Model for Assessing Concussion/Mild Traumatic Brain Injury (mTBI):
Concussion assessment is a complex and constantly evolving area of science and medicine. In recent years there has been a shift away from the grading model where concussions were assigned a grade based on things like whether or not there was a loss of consciousness. This model was a poor predictor of the post-concussion symptoms one might experience following mTBI and has been replaced by a far more prudent “symptoms-based” approach. We know now that someone who experiences what might previously have been referred to as a mild “Grade 1” concussion may still experience very serious post-concussion symptoms that are far more than “mild”.
Limitations of Imaging, and the Importance of Symptom Monitoring:
In many cases, imaging such as CT or MRI comes back clear, or normal, but that does not mean you have not suffered significant injury. Much of the damage to the brain following a concussion is at the cellular level in the form of what is called “diffuse axonal shearing”. This results in major metabolic changes to the brain as it begins to repair itself. These cellular and metabolic changes do not show up on standard imaging, but they do produce many common symptoms, which is why we rely heavily on self-reporting and tracking of symptoms during the recovery process.
As symptoms begin to subside, however, and you are trying to make important decisions about returning to previous activities, it can be very difficult to know what level of participation is safe or appropriate without concrete objective measures.
This is where some of the highly advanced neurovestibular diagnostic testing we do at Alberta Balance Centre can be of tremendous benefit.
Objective Measures and Baseline Testing:
Many of the tests we perform are highly sensitive to any impairments involving certain neural pathways associated with your inner-ears, eyes, and postural stability muscles that are commonly affected by mTBI/concussion. These objective measures give us valuable insight into your brain’s state of recovery, which is especially important when symptoms have become less severe and you’re not entirely sure if you have returned to “normal” again.
This brings up another important point: without any baseline measurements, it can be very difficult, if not impossible, to know what “normal” was prior to your concussion. For certain more objective tests, there are fairly narrow and clear-cut normative ranges. However, for many tests, such as those involving various cognitive tasks like memory and concentration, there can be a wide range of where you might score and still be considered normal. If we don’t know where you would have scored on a particular task prior to suffering a concussion, we don’t know if there has been any significant change as a result of it. For this reason, it is incredibly important to have baseline testing completed – especially for competitive athletes who may be eager to return to play as soon as possible.
Safety must always be the number one priority, especially when it comes to your brain, and having baseline data not only helps us determine the severity of your injury, it also gives us greater confidence in advising you when it is safe to return to play.
The Team Approach:
We recognize that a good post-concussion plan may include a wide range of professionals, such as your family doctor, sports medicine physician, neuropsychologist, physiotherapist, athletic therapist, personal trainer, occupational therapist, chiropractor, or nurse, just to name a few. This team approach is very valuable in that each profession is able to bring their own unique expertise to the collective goal of keeping you safe and helping you recover.
While maybe not typically on the radar of health care professionals managing concussion patients in the past, an audiologist specializing in neurovestibular diagnostics and rehabilitation can be an incredibly valuable member of any post-concussion team, and we would be happy to offer our expertise to help get you back to safely doing the things you love.
