Current Concepts in Concussion Management

Current Concepts in Concussion Management: A Strategic Approach to Rehab

COURSE DESCRIPTION

A multi-disciplinary team of professionals in the fields of orthopedic and sport physical therapy, vestibular rehab, neuro-optometry, and neuropsychology have come together to create this comprehensive course in concussion management. Patients present with an array of symptoms that must be approached from various lenses. The clinical profile may include involvement of the cervical spine, vestibular system, oculomotor system, autonomic nervous system, sleep dysfunction, migraine and post-traumatic headaches, anxiety, and cognitive fatigue. By gaining a more global understanding of managing patients will concussion, the clinician will become more efficient in clinical examination and involving a multi-disciplinary team of professionals to offer a more comprehensive treatment plan for the patient's recovery. Approved for 1.0 CEU's (10 Contact Hours) for PT and OT.

Course topics:

Concussion profile: recognizing and assessing the individual clinical domains and overlap of domains in clinical care
Principles of assessment and differential diagnosis
Cervical spine dysfunction as it contributes to oculomotor dysfunction, vestibular dysfunction, and headaches
Vestibular rehab approach to concussion management
Oculomotor assessment and treatment techniques from the perspective of neuro-optometry
Autonomic dysregulation
Neuropsychological considerations
Clinical pearls from specialists in orthopedic and sport physical therapy, vestibular rehabilitation, neuro-optometry and neuropsychology

LEARNING OUTCOMES

Describe the role and function of the nervous system and musculoskeletal structures commonly involved in post-concussion syndrome.
Recognize pre- and post-injury risk factors for protracted recovery.
Recognize the influence the cervical spine can have on patients with vestibular symptomology following a concussion mechanism of injury.
Perform a cervical spine examination to determine involvement in headache, migraine, dizziness, or radicular pain presentation.
Recognize nystagmus patterns and perform a vestibular exam for benign paroxysmal positional vertigo (BPPV) using proper positional tests for anterior, posterior, and horizontal canals.
Recognize the effects of anxiety, sleep, sensory processing, and cognitive fatigue in post-concussion syndrome.
Discuss the benefit of aerobic exercise in the post-concussion recovery and understand the underlying physiological mechanisms for this benefit.
Discuss prioritization of examination techniques for the initial evaluation and subsequent follow ups.
Discuss the clinical decision-making and progression for return to learn, work and play in concussion management.
Understand the importance of patient language, as it relates to conveying findings to highly anxious patients and/or parents.
Describe the roles of various health care providers in the multi-disciplinary approach to concussion management.
Recognize how prolonged symptoms of concussion impact ADL’s and IADL’s.

This course is approved by Wisconsin APTA for 1.0 CEU's (10 contact hours). Focus on Function Physical Therapy, PC is an AOTA Approved Provider of professional development. Course approval ID #9742. This course is offered at 1.0 CEU's, intermediate educational level, foundational knowledge. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

Online Course

$299.00

Online Only 1.0 CEU's (10 Contact Hours)

Register Today!

Course Curriculum

Module 1: Clinical Trajectory discusses risk factors for protracted recovery, discuss how initial symptom severity will affect recovery, and discuss best practice in early therapeutic intervention.
Module 2: Cervical Spine covers red flag screening, objective examination, and cervical spine influence on recovery from concussion.
Module 3: Vestibular and Balance addresses vestibular involvement in concussion, reviewing the multiple causes of dizziness, including BPPV, central and peripheral dysfunction, as well as appropriate assessment and treatment methods.
Module 4: Vision will be delivered by Jacqueline Theis OD, FAAO, FNAP, a neuro-optomitrist, providing education on assessment and treatment techniques appropriate in the rehab setting, and the role of the vision specialist as part of the care team.
Module 5: Exertion and Autonomic Dysregulation discusses the role of the autonomic nervous system and how this may be altered following concussion, as well as the benefit and timing of aerobic exercise.
Module 6: Neuropsychology Considerations will be delivered by Jesse Peterson PsyD, a neuropsychologist offering insight into the role of the mental health professional in concussion rehab
Module 7: Return to Learn, Work, Play covers the proper treatment progression, the role of the multi-disciplinary team, and the risk of re-injury and second impact syndrome.
Module 8: Clinical Pearls shares clinical experience in prioritization of exam and intervention progression, the use of outcome measures and sequencing of interventions based on the recent Clinical Practice Guideline and patient presentation.

Instructors

Zac Mestelle PT, DPT, OCS

Physical Therapist

Zac Mestelle, PT, DPT, OCS is a Doctor of Physical Therapy and a residency-trained board certified Orthopedic Clinical Specialist. Dr. Mestelle currently works at Bellin Health Titletown clinic where he treats a high volume of sports medicine patients. A large portion of this caseload includes rehab following ACL-R and other arthroscopic shoulder and knee surgeries. Additionally, he is also a member of Bellin’s throwing team which includes management of the injured thrower as well as performance based assessments. For the past three years Dr. Mestelle has led Bellin Health’s interdisciplinary concussion management team. This team includes physical therapists, occupational therapists, speech language pathologists and works intimately with the referring providers and school athletic trainers in order to provide optimal care for patients who have suffered a concussion. Dr. Mestelle graduated from the University of Wisconsin-La Crosse in 2017. It was on one of his terminal rotations where he initially gained exposure to evaluating and treating post-concussion patients as his clinical instructor was the lead physical therapist for the adolescent mild TBI team at Madonna Rehabilitation Hospitals. It was the challenge and uniqueness that comes with each post-concussion patient that led to Dr. Mestelle’s passion for treating these patients. Since then, he has worked diligently to gain a mastery in treating this specific patient population, through both formal continuing education courses as well as frequent review of the literature. Dr. Mestelle completed his Orthopedic Residency through Evidence in Motion and Bellin Health in 2020. While only a portion of patients with concussion require traditional orthopedic care, this residency helped Dr. Mestelle master the patient response model which has proven valuable for managing post-concussion patients. Dr. Mestelle’s purpose in teaching is to share the passion he has for this underserved patient population in an effort to improve patient outcomes and lead to a shorter and fuller recovery. He strives to instill the balance between high quality evidence-based information with pragmatic, experience, and application based information in order to provide a well-rounded learning experience.

Colleen Sleik PT, DPT, NCS

Physical Therapist

Colleen Sleik, PT, DPT, NCS, is a Doctor of Physical Therapy and a Neurologic Clinical Specialist, specializing in the treatment of patients with vestibular disorders. She has treated patients with vestibular disorders in a variety of settings over the years, including outpatient clinics, acute care, home health, skilled nursing facilities and private practice. Dr. Sleik currently works at Bellin Health in Iron Mountain, MI where her caseload consists of patients with dizziness, balance problems, post-concussion syndrome, neck pain and headaches. She was instrumental in developing Bellin’s Vestibular Specialty track. She developed coursework and training to establish baseline vestibular clinical competency for all new physical therapists in the organization and offers mentoring to support therapists throughout the health system. She is also an active member of Bellin Health’s concussion specialty track. Dr. Sleik graduated from The College of St. Catherine with a Master of Physical Therapy in 2003. She earned a transitional Doctor of Physical Therapy degree through The University of St. Augustine, Florida in 2010. In 2010, she completed the Competency-Based Vestibular Rehabilitation course through Emory University in Atlanta, Georgia and has continued her education by attending advanced vestibular rehab courses through the University of Pennsylvania, Pittsburgh and regularly attends the International Conference on Vestibular Rehab. Dr. Sleik is a board-certified Neurologic Clinical Specialist 2017-2027 and was previously a board-certified Orthopaedic Clinical Specialist 2012-2022. She is a member of the Vestibular Disorders Association (VEDA) and the American Physical Therapy Association, including the Academy of Neurologic Physical Therapists and the Vestibular Special Interest Group. Dr. Sleik lives and works in a small, rural community in Michigan where it is not uncommon for patients to drive several hours to access her specialty vestibular rehabilitation services. This need inspired her to begin teaching vestibular rehabilitation continuing education courses. She has been teaching national-level seminars in vestibular rehabilitation since 2015. Her goal is to increase clinicians’ knowledge and skills in vestibular rehabilitation, ultimately improving patient access to quality vestibular care. Dr. Sleik is pleased to have this opportunity to share her passion for treating this special population and guiding your journey in providing specialty care in vestibular rehabilitation.

Jack Cervantes PT, DPT, OCS

Physical Therapist

Jack Cervantes, PT, DPT, OCS is a Doctor of Physical Therapy and a residency-trained board certified Orthopedic Clinical Specialist. He currently works in the University of Wisconsin Hospital and Clinics Health System (UWHC). Dr. Cervantes graduated from the Carroll University Doctor of Physical Therapy Program in 2022 and completed the UW Hospital & Clinics and UnityPoint Health - Meriter Orthopaedic Physical Therapy Clinical Residency Program in 2023. He works with advanced spine and general orthopedic patients with a growing vestibular population in an outpatient setting at UWHC. Dr. Cervantes is working to increase his vestibular case load to promote more convenient access to vestibular care. He is a part of the Concussion Work Group with physical therapists with orthopedic and neurological specialties. As a clinician, Dr. Cervantes utilizes evidence-based treatment approaches to provide his patients with the best care available, while also providing them with strategies for long-term management. Dr. Cervantes’ interest in vestibular rehabilitation began following an intensive 8-week clinical experience with Dr. Sleik, treating patients with various diagnoses of dizziness. He has assisted in the development and presentation of Vestibular Rehab Certificate for Clinicians: Foundation and Clinical Application since 2023, educating both students and clinicians. This course has allowed Dr. Cervantes to pursue his passion and career goal of educating current and future clinicians as a way to give back and advance the profession of physical therapy.

Multi-Disciplinary Instructors

Jesse Peterson PsyD

Neuropsychologist

Jesse Peterson, PsyD, is a Doctor of Psychology practicing neuropsychology at Bellin Health in Green Bay, Wisconsin. Dr. Peterson’s interest in concussions and cognition began while playing DIII college football at Lawrence University in Wisconsin when the team completed its cognitive “baseline testing” during preseason camp. After reading the writing on the wall, which clearly indicated that slow, short runningbacks with bad hands had no opportunities to continue playing football after college, Dr. Peterson quickly transitioned into graduate school with a special interest in neuropsychology. Dr. Peterson earned his PsyD at Wheaton College, writing his dissertation on the performance validity indicators of a popular concussion assessment tool, and completed his predoctoral internship at the University of Missouri wing of the Missouri Health Sciences Psychology Consortium. He went on to complete postdoctoral fellowships at the University of Missouri and University of Wisconsin to gain broad experience with adult neuropsychology patients, conducting outpatient and inpatient evaluations for patients experiencing traumatic brain injuries of all severities, dementia, stroke, epilepsy and other neurologic disorders, neurodevelopmental disorders, and psychiatric complications. Though a neuropsychological generalist, a large portion of Dr. Peterson’s current patients include individuals experiencing the subacute and chronic cognitive effects of traumatic brain injuries, including concussions.

Jacqueline Theis OD, FAAO, FNAP

Optometrist trained in Neuro-Optometry

Jacqueline Theis OD, FAAO, FNAP is a practicing optometrist, clinical researcher, international lecturer and author. She received her doctoral and post-doctoral residency training in Neuro-Optometry and Binocular Vision disorders from the University of California at Berkeley School of Optometry. She is a previous Assistant Clinical Professor and the Founder and Chief of the UC Berkeley Sports Vision and Concussion Clinic and currently serves as an Assistant Professor for the Uniformed Services University, School of Medicine, Department of Physical Medicine and Rehabilitation. She has extensive clinical experience in post-traumatic brain injury and neurologic visual dysfunctions including neuropathic eye pain, neurologic dry eye, cranial nerve palsies, oculomotor dysfunction, photophobia, visual processing, and visuo-vestibular symptoms. She serves as a member of the Intrepid Eye Society, the American Optometric Association Evidence Based Optometry and Vision Rehabilitation Committees and is a fellow of the American Academy of Optometry and the National Academies of Practice

The Concussion Profile screen is a 29-item self-reporting tool in which the patient to rates their symptom severity on a scale of 0-3 to assess the clinical presentation in the following domains:

Anxiety/mood
Cognitive fatigue
Migraine
Ocular
Vestibular
Sleep
Cervical spine

Clinically, this tool can be used to guide questions, assessments, and possible discussions about specialty referrals and lifestyle modifications.

Click HERE to access the article.