Leah Trostad

Northland Community and Technical College

Occupational Therapy Assistant Program
Critically Appraised Topics Assignment

Focused Question:

What is the role of Occupational Therapy in the treatment of a sports related concussion?

Clinical Scenario:

According to Mayo Clinic (2017), a concussion is a traumatic brain injury that affects your brain

function. They report that the effects are usually temporary but can include headaches and

problems with concentration, memory, balance and coordination. They also state that

concussions are usually caused by a blow to the head and they report that violently shaking the

head and upper body can also cause concussions.

The American Association of Neurological Surgeons [AANS] (2018), states that more

than 300,000 sports-related concussions occur annually in the U.S. and the likelihood of

suffering a concussion while playing a contact sport is estimated to be as high as 19 percent per

year of play. They further state that more than 62,000 concussions are sustained each year in high

school contact sports and among college football players, 34 percent have had one concussion

and 20 percent have endured multiple concussions. According to Brain Line (2018), sports and

recreation-related concussions are the leading cause of TBI-related emergency department visits

among children and teens. “Most people completely recover from their concussions, but it may

take months for the symptoms to disappear” (Health Line, 2018). This research is to determine

occupational therapies role in concussion treatment.

Summary of Key Findings:

 Level I:

Hyperbaric Oxygen Therapy Can Improve Post-Concussion Syndrome Years after Mild
Traumatic Brain Injury- Randomized Prospective Trial; Boussi-Gosse, Golan, Fishlev,
Bechor, Bolkov, Volkob and Bergan (2013)

This randomized, controlled, two group trial was to evaluate the effects of hyperbaric oxygen

therapy on the brain and cognitive impairments for those who experienced prolonged symptoms

of post-concussion syndrome. This study included 56 individuals 18 and older who had all

signed a consent form and were placed into an experimental or crossover group. The patients in

the crossover group were evaluated three times, at baseline, after two months of no treatment and

then again at two months of Hyperbaric Oxygen Therapy, HBOT. The patients in the

experimental group were evaluated twice, once at baseline and then again after two months of

HBOT. There were significant improvements in the treated group and the crossover group after

HBOT in the cognitive tests. The results of this study inform us that hyperbaric oxygen therapy

may induce neuroplasticity and improve overall brain function for those with concussions or

mild traumatic brain injuries that present with post-concussion syndrome at a later age or even

years after the incident occurred.

A Systematic Review of Hospital-to-School Reintegration Interventions for Children and

Youth with Acquired Brain Injury; Lindsay, Hartman, Reed, Gan, Thompson and Solomon
(2015)

The authors reviewed 17 articles on hospital to school interventions for children with Acquired

Brain Injury (ABI). Six of the studies were classified as level 1, three of the interventions were

group-based, and the others were one on one. The sample sizes in the studies varied from

between 2-72 participants. The majority of the individuals had severe ABI’s and two of the

articles had children with brain tumors. The interventions used were arts-based activities,
problem solving activities, clinician-led information sessions, cognitive and behavioral therapy,

family/social support and multi-component interventions. The arts-based intervention focused on

delivering social skills in a hospital based classroom to youth ages 13-16 with moderate to severe

ABI. There were 20 group sessions lastly roughly four hours each, four days a week. They

worked on voice work, movement, physical warm up, breathing, writing skills, etc. The clinician

led injury information sessions completed over the course of a month, were given at participant’s

homes, was targeted for youth ages 9-16 years old with severe ABI’s. The clinicians helped the

individuals create a timeline on their accident. Family supported intervention was implemented

in the homes to children ages 5-12 years of age with severe ABI’s. Occupational therapists used

problem solving skills to ages 8-18 that helped with ABI’s and brain tumors. It was given

through 14 group sessions that lasted 3 hours each. Cognitive rehabilitation was given at home to

ages 7-19 that focused on working on memory, attention, and exercises to assist in patient’s

performances. Two of the studies had significant improvements in knowledge on ABI’s, seven

studies reported improvements in cognitive functioning, several studies reported improvements

in social functioning such as interpersonal negotiation strategies, problem solving and social

contacts. Two studies reported significant improvements in behavior and three studies had

improvements in psychological functioning. A holistic approach is the most appropriate to

rehabilitation I the best option for students with mild, moderate and severe ABI. Interventions

that significantly improved youth’s and educator’s knowledge of ABI were delivered in a one on

one setting. Interventions that improved cognitive functioning commonly took place in the home,

were delivered one on one, had homework and were performed 7 weeks to a year. Interventions

that had a very big impact on social functioning took place at school or online at home, these

ranged from 7-16 weeks. Finally, interventions that affected psychological functioning were
delivered in a variety of settings, one on one, had parent/sibling involvement and ranged from

10-24 weeks.

Level II:

Occupational Therapy Outcomes for Clients with Traumatic Brain Injury and Stroke
Using the Canadian Occupational Performance Measure; Phipps and Richardson (2007)

This retrospective study consisted of 155 adult participants between the ages of 19 and 82 who

participated in outpatient OT. Approximately 38 of the individuals involved had a traumatic brain

injury, 117 of the participants were diagnosed with a cerebrovascular accident. The mild

traumatic brain injury group (TBI) approximately 20 years younger reported their primary

occupational roles as being worker, student and player. The focus of this study was to examine

whether people who experience outpatient services of OT with mild traumatic brain injuries and

cerebrovascular accidents show an increased level of satisfaction and occupational performance

in activities of daily life by using the Canadian Occupational Performance Measure (COPM).

The data was collected through an outpatient therapy clinic at a rehab center. The clients received

two 45-90 minute sessions of therapy per week for 4-12 weeks. The duration and frequency

depended on the goals of the client and the severity of their neurological disorder. Some of the

participants received speech and physical therapy services as well. This program was focused on

treatment goals each client made using the COPM. There was a total of 901 occupational therapy

performance goals that were analyzed. The mean change was 3.29 points in performance from

admission to discharge and a mean change in satisfaction from admission of 3.53 points across

all groups. Some studies show that a change of 2 or more points on the COPM typically

represent at least .75 of a standard deviation which is considered a large change of importance.

All changes in this study were well over 2 points, ranging from 2.85-4.07 points. There were

significant differences (p < .001) for all groups between the pre- and post-intervention scores of
the entire group. There were no significant differences between the pre- and post-intervention

scores for performance between the diagnostic groups (p=.08). But there was a significant

difference between the pre- and post-intervention scores between satisfaction of the right to the

left CVA group (p = .03). The right CVA group had an increase in satisfaction compared to the

left CVA group. The greatest number of goals identified were involving occupational

performance in self-care and home management. Each diagnostic group showed a significant

increase in performance and satisfaction.

Level III:

Outcomes Following a Vestibular Rehabilitation and Aerobic Training Program to Address

Persistent Post-Concussion Symptoms; Moore and Adams (2016)

This study consisted of a 6-month home exercise program for adults that experienced persistent

symptoms and any other disabilities following a concussion. This aimed to investigate changes

over time in adults that had experienced a concussion. There were 14 individuals involved in the

study, these individuals participated in a home exercise program which focused on vestibular

rehabilitation along with aerobic training. Each session was approximately 45 minutes; the three

exercises completed were to address vestibular rehabilitation that included gaze stabilization,

sensory organization and gait. Another intervention utilized was aerobic exercise training, 9 of

the individuals received vision therapy, the other 5 received psychology services, orthopedic

physical therapy, and cognitive behavioral therapy. There were significant improvements after

using the 6-month home exercise vestibular program for concussion related symptoms, function

and return to meaningful activities. There was no association found between age group and

return to work, or age group and return to meaningful activities at any time during the 6-month

period.
Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative
Adjunct iCon; Ahmed and McCrory (2017)

This observational study was performed on eleven individuals over a 3-month period. This

program was conducted over a 90-day time period which was a requirement for iCon to be given

during the winter sports season for those who experienced concussions. Each participant had to

complete a pre-intervention interview over the phone to collect important information and data.

The Sport Concussion Assessment Tool (SCAT2) was used to measure the severity of symptoms.

The post-intervention interview was completed a week after completing iCon. ICon included

important information on concussions, websites to look through, videos to watch, daily posts and

polls for the participants to answer. Results of this study found that all 11 participants would

recommend iCon to others who are experiencing a concussion. They also stated that their

decisions to return to play (RTP) were influenced by iCon. There was a reduction of symptoms

for the individuals who used this program and all quotes taken by the participants at the end

supported iCon as it improved symptoms of concussions.

Level IV:

Management of Persistent Cognitive Symptoms After Sport-Related Concussion; Sohlberg

and Ledbetter (2016)

This study consisted of 24 individuals between the ages of 14-26 years old who were in middle

school, high school or attending college that participated in sports that experienced persistent

cognitive and somatic symptoms from a concussion. This study examined a wide variety of

treatment options speech pathologists used and the rationale for each option. The study also

examined if the individuals needed any accommodations in school after a concussion had been

diagnosed. The treatments used in this study were direct education training (DAT), metacognitive
strategy instructions (MSI), training assistive technology for cognition (ATC), and

psychoeducational supports to help enhance the patient’s performance in school. A total of 13

patients received DAT, 9 patients received MSI, 5 patients received ATC and all 24 patients

received psychoeducational support. Roughly 83% of the patients accomplished self-selected

functional goals. The research was focused on returning to play and educational accommodations

in the first weeks after a concussion. The results of this study showed that speech language

pathologists delivered interventions that lead to positive outcomes. Outcomes were measured by

assessment of whether they met their expected level of improvement on the goals they selected

within their functional goal domain. The treatment with the best outcomes were in the DAT

treatment as 13 clients met self-selected goal. Twenty-two clients who received

psychoeducational support met their self-selected functional goals.

Mild Traumatic Brain Injury: A Review of Current Occupational Therapy Practice in

Aotearoa New Zealand’s Acute Settings; Carmel Tan-Rapues (2018)

This study consisted of survey questionnaires that were sent out to occupational therapists who

work with mild traumatic brain injuries and concussions. The focus of this study was to

determine the role occupational therapists play on a day to day basis with the two injuries. There

were 28 questionnaires that were sent out and all 28 were returned but only 26 were usable as

one came back blank and the other was from a community-based occupational therapist, of the

majority 93%, were occupational therapists who worked in an acute care setting. Approximately

20-30% of the individuals that, the therapists saw had mild traumatic brain injury and/or

concussions. The survey showed that occupational therapists play an important and significant

role in the assessment and management of acute cognitive deficits and concussion symptoms

from post-mild traumatic brain injuries in acute care settings. The average length of stay for the
patients was more than 24 hours but less than 48 hours. Length of stay in the orthopedic ward

increased up to 6 days and 3 days in the surgical ward. There are full time occupational therapist

working in admissions and in the emergency department working with concussions.

Level V:

Managing Mental Health Aspects of Post-Concussion Syndrome in Collegiate Student-

Athletes; Hamson-Utley, Arvinen-Barrow and Clement (2017)

This case report was performed on a male in basketball who had been diagnosed with a

concussion. Seth was having concussion related symptoms 28 days after his concussion, this had

started to affect his progress and sustained attention in school. It was focused on evaluating the

diagnosis, identifying psychosocial interventions used to help enhance those with mental health

referrals and to recognize any other health professionals that need to be in the process of

returning to the basketball court after suffering from a concussion. Psychosocial interventions

used to treat post-concussion syndrome include cognitive behavioral therapy, patient education,

relaxation strategies, sleep monitoring, aerobic exercise and submaximal aerobic exercise. A few

of these interventions were used with Seth to help treat the psychosocial symptoms he was

exhibiting. Cognitive behavioral therapy was effective for individuals who experienced post-

concussion syndrome and was very beneficial if it is started right away. Cognitive behavioral

therapy is important in the recovery process which tries to limit negative thinking and helps you

become more aware of irrational thoughts by viewing the situation more differently. The

cognitive behavioral therapy showed a decrease in anxiety and depression symptoms. Seth’s

psychological care consisted of cognitive behavioral therapy, mental relaxation strategies such as

deep breathing independently at home and proper sleep. Patient education was important as the

client’s academic routine was disrupted due to his concussion. Seth was educated on post-

concussion syndrome, how long the symptoms persist and how much cognitive activity he
should be engaging in. Patient education lowers anxiety, reduces stress and improves sleep

among the individuals. Relaxation strategies and mental skills were ways of reducing the

incidence and duration of symptoms. Relaxation strategies reduce symptoms that may increase

stress. Sleep monitoring is important to track sleeping patterns by using a diary, using a Fitbit,

and getting enough rest. Rest includes taking a break from physical activities, technology use and

texting time. A counselor, psychologists and psychiatrist should also be involved to ensure the

best care possible for the individual. The psychosocial functioning was improved overall to those

who experience mental health related difficulties while experiencing post-concussion syndrome.

Occupational Therapy for Service Members with Mild Traumatic Brain Injury;
Randomski and Davidson (2009)

This article summarizes recommendations that occupational therapy professionals can utilize for

service members with mild traumatic brain injury. There are many different assessments and

interventions in the rehabilitation and reintegration efforts of service members to improve their

physical, emotional and social well-being after being diagnosed with a mild Traumatic Brain

Injury. Interventions discussed in this article included client education, vision and cognition

tools. A standardized evaluation for vision is the Brain Injury Visual Assessment Battery for

Adults and the Northern State University College of Optometry Test. Vision interventions

include exercises to strengthen ocular muscles and improve convergence, engaging in activities

that require gross motor movements and identifying visual targets. Evaluations used for self-

awareness include the Mayo-Portland Adaptability Inventory and the Self-Awareness of Deficit

Interview. Interventions used for self-awareness include money management, household, or

stimulated work tasks. Evaluations used for cognition include COGNITISTAT, Contextual

Memory Test, Rivermead Behavioral Memory Test and Test of Everyday Attention. There are

many strategies available for occupational therapy interventions that may be used but should be
looked over by an optometrist for an evaluation of ocular health and functions. Occupational

therapists can give low vision and visual perceptual screens. It is important for the occupational

therapist to note any strange behaviors or squinting, overreaching or dizziness when ambulating

or changing positions.

Bottom Line for Occupational Therapy Practice:

The purpose of this research was to determine the role of occupational therapy in the

treatment of sports related concussions. Occupational therapy professionals should be

knowledgeable about Hyperbaric Oxygen therapy as Boussi-Gross, Golan, Fishlev and Bechor

(2013), found that it can induce neuroplasticity which leads to the repair of impaired brain

functions. It is also important that occupational therapy professionals are aware of the

importance of cognitive and physical rest as noted by Sohlberg and Ledbetter (2016). Hamson-

Utely (2017), found that psychological factors play a significant role following sports related-

concussions. He noted that the care of athletes following a concussion includes cognitive

behavioral therapy, proper patient education, relaxation strategies and sleep monitoring to be

proper interventions used for those experiencing psychological symptoms following a sports-

related concussion. Lindsay et. al. (2015), found that hospital to school reintegration used

interventions such as arts-based activities, computerized problem-solving activities, clinician-led

information sessions, cognitive and behavioral therapies, family/social support groups and multi-

component interventions which are all areas occupational therapy specializes in.

According to Radomski, Davison, Voydetich & Erickson (2009) found that occupational

therapists can implement vision interventions such as exercises to strengthen ocular muscles and

improve convergence, engaging in activities that require gross motor movements and identifying

visual targets. Moore, Adams and Barakatt (2016) state that vestibular rehabilitation programs
focus on activities such as gaze stabilization, sensory organization and gait along with aerobic

training significantly improve concussion related symptoms, function and return to meaningful

activities which occupational therapy focuses on.

According to Rapues (2018), occupational therapists play a significant role in the

assessment and management of mild traumatic brain injuries in an acute setting. Rapues noted

that the Westmead Post-Traumatic Amnesia Scare (WPTAS) is used to monitor, diagnosis,

manage and treat a mild traumatic brain injury. He further stated that the Rivermead Post

Concussion Symptoms Questionnaire (RPQ) is used as a self-report to measure symptom

frequency, intensity and duration after a brain injury. He reports that this information is useful in

the course of treatment. According to Radomski, Davison, Voydetich & Erickson (2009),

occupational therapy professionals can utilize many assessments and interventions in the

rehabilitation and reintegration of service members to improve their emotional, physical and

social well-being after being diagnosed with a mild traumatic brain injury. They note that

assessments used by occupational therapists for vision included the Brain Injury Visual

Assessment Battery for Adults and the Northern State University College of Optometry Test.

Assessments used for self-awareness included the Mayo-Portland Adaptability Inventory and the

Self-Awareness of Deficit Interview. Finally, they note assessments used for cognition included

COGNITISTAT, Contextual Memory Test, Rivermead Behavioral Memory Test and Test of

Everyday Attention.

Occupational therapy professionals can implement programs such as iCon to ensure

proper education to the individuals on the safe return to play of young individuals after a

concussion. Ahmed, Schneiders, McCrory & Sullivan (2017), found that the Facebook program,

iCon improves the management of a sports related concussion symptoms by educating the
individual who is experiencing these symptoms in order to return to play following a concussion.

They note that the program, iCon includes important concussion information, websites to

explore, videos to watch and daily posts/polls to participate in. Sohlberg and Ledbetter (2016)

state that the best treatments for returning to play are direct attention training, metacognitive

strategy instruction, training assistive technology for cognition and psychoeducational support.

Overall, there are many different interventions to help treat sports related concussions.

Boussi-Gross, Golan, Fishlev and Bechor (2013), found that occupational therapists can

recommend Hyperbaric Oxygen therapy which can induce neuroplasticity which leads to the

repair of impaired brain functions. Hamson-Utely (2017), found that occupational therapists can

treat the psychological factors that play a significant role following sports related-concussions.

The factors include cognitive behavioral therapy, proper patient education, relaxation strategies

and sleep monitoring to be proper interventions used for those experiencing psychological

symptoms following a sports-related concussion. Radomski, Davison, Voydetich & Erickson

(2009) found that occupational therapists can implement vision interventions such as exercises to

strengthen ocular muscles and improve convergence, engaging in activities that require gross

motor movements and identifying visual targets.

Rapues (2018) found that occupational therapists can use the Westmead Post-Traumatic

Amnesia Scare (WPTAS) to monitor, diagnosis, manage and treat a mild traumatic brain injury.

He further stated that the Rivermead Post Concussion Symptoms Questionnaire (RPQ) can be

used as a self-report to measure symptom frequency, intensity and duration after a brain injury.

Radomski, Davison, Voydetich & Erickson (2009) state that occupational therapy professionals

can utilize vision assessments that include the Brain Injury Visual Assessment Battery for Adults

and the Northern State University College of Optometry Test. Assessments used for self-
awareness include the Mayo-Portland Adaptability Inventory and the Self-Awareness of Deficit

Interview. Finally, they note that the COGNITISTAT, Contextual Memory Test, Rivermead

Behavioral Memory Test and Test of Everyday Attention can be used by occupational therapists

to determine different cognition levels. Ahmed, Schneiders, McCrory & Sullivan (2017), found

that occupational therapists can utilize the Facebook program, iCon which improves the

management of a sports related concussion symptoms by educating the individual who is

experiencing these symptoms with information on concussions, videos, posts and websites in

order to return to play. Sohlberg and Ledbetter (2016) states that the best treatments occupational

therapists can use for returning to play are direct attention training, metacognitive strategy

instruction, training assistive technology for cognition and psychoeducational support following

a concussion.

Review Process:

Inclusion Criteria:
Concussions and or Mild TBI
1940 and present
All ages

Exclusion Criteria:
1940 and older

Search Strategy:

Categories Key Search Terms

Patient/Client Population Concussions and Therapy, Occupational
Therapy with Sports Concussions
Intervention Treatment for Sports Related Concussions,
Hyperbaric Oxygen Therapy treatment for
Concussions, Mild Traumatic Brain Injury
Interventions, Interventions for Post-
Concussion Syndrome, Interventions for
Concussions from Sports Related Injuries,
Interventions for Concussions, Mild
Traumatic Brain Injury with Occupational
 Therapy Interventions
Comparison N/a
Outcome Occupational Therapy and Concussions,
Traumatic Brain Injury in Sports with
Occupational Therapy, Sports Related
Concussions with Occupational Therapy

Databases and Sites Searched:

Databases:
Ebscohost
ProQuest

Sites: N/A

Quality Control/Peer Review Process:

This topic question was creating using PICO to further understand what occupational
therapy interventions are best to use with sports related concussions. After forming the question,
the clinical scenario was created to support the need for further research on this topic. Lastly,
research was conducted and there was a conclusion found. There were nine research articles that
were found, and the key findings/information was taken out and analyzed to help support the
research question above. The bottom line reviewed key evidence to answer the research question.
This document was peer reviewed by two different classmates and the course instructor, Kara
Welke to ensure that all the information was stated correctly.

Results of Search:

Summary of Study Designs of Articles Selected for Appraisal:

Level of Evidence Study Design/Methodology of Selected Number of Articles
Articles Selected
Level I Systematic reviews, meta-analysis, 2
randomized controlled trials
Level II Two groups, nonrandomized studies 1
(e.g., cohort, case-control)
Level III One group, nonrandomized (e.g., before 2
and after, pretest, and posttest)
Level IV Descriptive studies that include analysis 2
of outcomes (single subject design, case
series)
Level V Case reports and expert opinion, which 2
include narrative literature reviews and
 consensus statements
Qualitative N/a

Limitations of the Studies Appraised:

Level I:

Hyperbaric Oxygen Therapy Can Improve Post-Concussion Syndrome Years after Mild
Traumatic Brain Injury- Randomized Prospective Trial; Boussi-Gosse, Golan, Fishlev,
Bechor, Bolkov, Volkob and Bergan (2013)

This article doesn’t specifically target occupational therapy. It also only focused on 18 year olds

and above who experienced post-concussion syndrome.

A Systematic Review of Hospital-to-School Reintegration Interventions for Children and

Youth with Acquired Brain Injury; Lindsay, Hartman, Reed, Gan, Thompson and Solomon
(2015)

The articles consisted of small, medium and large sample sizes, but were mainly smaller and

were considered heterogeneous. There were many unstandardized outcomes that were measured

such as social skills, participation, attention/memory and etc. Due to the unstandardized

measures, this limited their ability to notice the effectiveness across interventions and studies.

Some of the interventions were tailored to certain participants which limits this article by how

reliable it is. Some of the studies had unclear components involved in the study. This article did

not focus specifically on concussion related to sports related injuries.

Level II:

Occupational Therapy Outcomes for Clients with Traumatic Brain Injury and Stroke
Using the Canadian Occupational Performance Measure; Phipps and Richardson (2007)

This study does not specifically target sports injuries and concussions. There were no controls for

recovery, premorbid characteristics, nature and locus of brain damage, occupational therapy,

original onset of evaluation, duration and frequency of treatment. The evaluator assisted the
client in identifying goals the therapist believed was easier to achieve. There was not a control

group, a wide range of interventions were used and the reliability of the five evaluators was not

assessed.

Level III:

Outcomes Following a Vestibular Rehabilitation and Aerobic Training Program to Address

Persistent Post-Concussion Symptoms; Moore and Adams (2016)

This is a small sample size (n=14) and it does not specifically target occupational therapy. They

also limited their population to 18 years and older. They left out a big age group that may see

more concussions than those of the older population that are in high school.

Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative

Adjunct iCon; Ahmed and McCrory (2017)

Limitations in this study include how using Facebook while experiencing a concussion

contradicts the idea that rest helps those with concussions heal faster. Constantly looking at a

screen is not good for your eyes especially when experiencing a concussion. Also, individuals

selected for this study only included those in sports during the winter instead of those in sports

throughout the year. There was a small sample size (n=9) only including a small age gap, which

does not include those who are younger in sports under the age of 16. There were way more men

than there were women included in the study. This study did not address occupational therapy

specifically.

Level IV:

Management of Persistent Cognitive Symptoms After Sport-Related Concussion; Sohlberg

and Ledbetter (2016)
The article does not specifically target occupational therapy. Also, the study had a small sample

size (n=24) which makes this article not as reliable.

Mild Traumatic Brain Injury: A Review of Current Occupational Therapy Practice in

Aotearoa New Zealand’s Acute Settings; Carmel Tan-Rapues (2018)

Limitations include only 28 of the questionnaires being returned and only being able to use 26 of

them for this study. None of the research or guidelines of the study actually thoroughly defined

the role of the occupational therapist or the exact tools that were being used in acute care settings

for those with mild traumatic brain injuries or concussions. This study does not specifically

target the prevention or treatment of concussions which is a part of the research question.

Level V:

Managing Mental Health Aspects of Post-Concussion Syndrome in Collegiate Student-

Athletes; Hamson-Utley, Arvinen-Barrow and Clement (2017)

The cognitive and physical symptoms vary greatly upon the individual including the different

mental health problems each person may exhibit. This report does not specifically target

occupational therapy but it does provide interventions to use with those experiencing post-

concussion syndrome. There were no actual interventions performed on this individual.

Occupational Therapy for Service Members with Mild Traumatic Brain Injury;
Randomski and Davidson (2009)

This study focuses its’ findings on service members returning from duty rather than young

athletes with sports related concussions.

 Articles Selected for Appraisal:

Ahmed, O. H, Schneiders, A. G, McCrory, P. R, & Sullivan, S. J. (2017). Sport concussion

management using facebook: A feasibility study of an innovative adjunct

''iCon''. Journal of Athletic Training, 52(4), 339-349.

doi:http://dx.doi.org.nctproxy.mnpals.net/10.4085/1062-6050-52.2.13

Boussi-Gross, R., Golan, H., Fishlev, G., Bechor, Y., Volkov, O., Bergan, J., . . . Efrati, S. (2013).

Hyperbaric oxygen therapy can improve post-concussion syndrome years after mild

traumatic brain injury - randomized prospective trial.PLoS One, 8(11)

doi:http://dx.doi.org/10.1371/journal.pone.0079999

Hamson-Utley, J., Arvinen-Barrow, M., & Clement, D. (2017). Managing mental health aspects

of post-concussion syndrome in collegiate student-athletes.Athletic Training & Sports

Health Care, 9(6), 263-270. doi:http://dx.doi.org.nctproxy.mnpals.net/10.3928/19425864-

20171010-05

Lindsay, S., Hartman, L. R., Reed, N., Gan, C., Thomson, N., & Solomon, B. (2015). A

Systematic Review of Hospital-to-School Reintegration Interventions for

Children and Youth with Acquired Brain Injury. PLoS ONE, 10(4), 1–19.

https://doiorg.nctproxy.mnpals.net/10.1371/journal.pone.0124679

Moore, Brian, Adams, Joseph, & Barakatt, Edward (2016). Outcomes following a vestibular

rehabilitation and aerobic training program to address persistent post-concussion

symptoms: An exploratory study. Journal of Allied Health, 45(4), E59-E68.

Retrieved from http://nctproxy.mnpals.net/login?url=https://search-proquest-

com.nctproxy.mnpals.net/docview/1859416615?accountid=40780

Phipps, S., & Richardson, P. (2007). Occupational therapy outcomes for clients with traumatic

brain injury and stroke using the canadian occupational performance

measure. The American Journal of Occupational Therapy, 61(3), 328-34.

doi:http://dx.doi.org.nctproxy.mnpals.net/10.5014/ajot.61.3.328

Radomski, M. V., Davidson, L., Voydetich, D., & Erickson, M. W. (2009). Occupational therapy

for service members with mild traumatic brain injury. The American Journal of

Occupational Therapy, 63(5), 646-55.

doi:http://dx.doi.org.nctproxy.mnpals.net/10.5014/ajot.63.5.646

Sohlberg, M. M., & Ledbetter, A. K. (2016). Management of persistent cognitive symptoms after
sport-related
concussion. American Journal of Speech - Language Pathology (Online), 25(2), 1-12.
doi:http://dx.doi.org/10.1044/2015_AJSLP-14-0128

Tan-Rapues, C. (2018). Mild traumatic brain injury: A review of current occupational therapy

practice in aotearoa new zealand's acute settings. New Zealand Journal of Occupational

Therapy, 65(1), 28-35. Retrieved from http://nctproxy.mnpals.net/login?

url=https://search-proquest- com.nctproxy.mnpals.net/docview/2062900052?accountid=40780

Other Resources Utilized:

American Association of Neurological Surgeons (2018). Sports-related Head Injury. Retrieved

from https://www.aans.org/Patients/Neurosurgical-Conditions-and-

Treatments/Sports- related-Head-Injury

Brain Line (2018, August 28). Concussion and Sports. Retrieved from

https://www.brainline.org/article/concussion-and-sports

Health Line (2017). Concussion: Symptoms, Diagnosis, and Treatments. Retrieved from

https://www.healthline.com/health/concussion#complications

Mayo Clinic (2017, July 29). Concussion. Retrieved from https://www.mayoclinic.org/diseases-

conditions/concussion/symptoms-causes/syc-20355594