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Active Rehabilitation After Childhood and Adolescent Mild Traumatic Brain Injury: a Narrative Review and Clinical Practice Implications

  • Pediatric Rehabilitation Medicine (A Houtrow and M Fuentes, Section Editors)
  • Published:
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Abstract

Purpose of Review

Development of rehabilitation strategies for youth after mTBI can be challenging for the rehabilitation professional. The purpose of this narrative review is to highlight current evidence for the use of active rehabilitation to manage common impairments after concussion/mild traumatic brain injury (mTBI).

Recent Findings

Exertional intolerance, vestibular deficiency, visual problems, and cervical dysfunction are common after mTBI. Active rehabilitation strategies targeting these problems are likely effective at reducing these impairments, leading to improved functioning.

Summary

Active rehabilitation recommendations for mTBI are evolving rapidly. There appears to be consensus that various impairment domains can be targeted with exercise and education after a thorough evaluation. More rigorous studies within the youth population are needed to move the field toward individualized, active rehabilitation strategies for youth after mTBI.

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Abbreviations

mTBI:

Mild traumatic brain injury

RCT:

Randomized clinical trials

VOMS:

Vestibular/Ocular Motor Screening

DVA:

Dynamic visual acuity

MST:

Motion sensitivity test

DHI:

Dizziness Handicap Index

VT:

Vestibular therapy

ROM:

Range of motion

CROM:

Cervical range of motion

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jason A. Hugentobler & Catherine Quatman-Yates

  2. Department of Physical Therapy, The Ohio State University, Columbus, OH, USA

    Catherine Quatman-Yates

  3. Division of Physical Medicine and Rehabilitation, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 4009, Cincinnati, OH, 45229-3026, USA

    Nathan K. Evanson, Andrea Paulson, Caitlin Chicoine, Barynia Backeljauw, Christina L. Santia & Brad G. Kurowski

  4. Departments of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Nathan K. Evanson, Andrea Paulson & Brad G. Kurowski

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Brad Kurowski reports grants from NIH outside the submitted work. Jason Hugentobler, Catherine Quatman-Yates, Nathan Evanson, Andrea Paulson, Caitlin Chicoine, Barynia Backeljauw, and Christina L. Santia declare no conflicts of interest relevant to this manuscript.

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Hugentobler, J.A., Quatman-Yates, C., Evanson, N.K. et al. Active Rehabilitation After Childhood and Adolescent Mild Traumatic Brain Injury: a Narrative Review and Clinical Practice Implications. Curr Phys Med Rehabil Rep 7, 15–22 (2019). https://doi.org/10.1007/s40141-019-0207-3

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