Traumatic brain injury (TBI) within youth, defined by the Centers for Disease Control and Prevention as an injury to the head that causes disruption of the normal function of the brain, is fast becoming an issue of concern for parents across the United States. High-profile incidents of TBI reported in professional athletes have sparked conversations on the safety of youth participation in a variety of sporting activities including hockey, boxing, soccer and full-contact football. TBI that occurs during sporting events is only the tip of the iceberg. TBI also occurs frequently because of falls, motor vehicle accidents, fights and physical abuse perpetrated by adults. Hence, youth between the ages of 15 to 19 are one of the highest-risk groups to experience TBI, and the consequences of this high rate of TBI within youth are diverse and far reaching. TBI within youth have been shown to be associated with higher levels of anxiety, depression, attention deficit and hyperactivity disorder, attempted suicide, and abuse of alcohol and/or drugs. Furthermore, TBI has also been shown to increase criminal behavior by youth and lead to their later involvement with law enforcement. A systematic review of research found that TBI is approximately three times more … Continue reading →

"Historically, integrating new evidence into provider behavior can take many years. However, we demonstrated a rather robust and quick uptake of several recommended clinical strategies, even ones new to many primary care providers," says Kristy Arbogast, PhD, lead author and co-director of CHOP's Center for Injury Research and Prevention. "The EHR platform allowed us to provide clinical practice guidance across our geographically and socio-economically diverse network, and promote systematic implementation and documentation of emerging recommended practices. We want all patients to get 'CHOP-level care' no matter where they enter our system." The study's results highlight that in the two years leading up to the intervention, neither management strategy was implemented and documented consistently or systematically. In the pre-intervention period, performance of the vestibular oculomotor exam was documented in the EHR for only 1.8 percent of concussion visits. In contrast, 71 percent of visits in the post-intervention period included evidence of this exam for an overall 129 percent increase from July 2012 to June 2014. During the pre-intervention period, 19 percent of concussion visits included EHR documentation of sharing return-to-learn and return-to-play guidelines. In contrast, in the post-intervention period these phrases were found in 73 percent of EHRs for a total … Continue reading →

Research that shows activity aids recovery for concussion patients has been adopted by experts in the field. New guidelines published this month in the British Journal of Sports Medicine are intended to guide clinical practice, as well as future research in the field of sport-related concussion. The guidelines include research by John J. Leddy, MD, clinical professor of orthopaedics, and Barry S. Willer, PhD, professor of psychiatry. The 2017 Concussion in Sport Group drafted new guidelines on how to best treat concussion for individuals ages 6 and older. For the first time, the recommendation for prolonged complete rest post-concussion was updated. We are not saying, after a concussion, go crazy and resume life as if nothing happened, says Leddy, an adjunct professor of rehabilitation science. What we are saying is that after two days of complete rest, if your symptoms have stabilized and you are starting to feel better, then it is OK to start to gradually do life activities and get your heart rate up a little. Dont just sit in a bed with the lights off. Guidelines are released every four years to reflect updates that have taken place in the field of concussion research, he says. The … Continue reading →