Evidence Based Assessment and Treatment of Concussion


Organized by the North American Brain Injury Society (NABIS)

Presenters will describe the evolution of the physiological model for assessment and treatment of individuals with acute or chronic concussion effects. They will review the relevant animal and human research that provided our in depth understanding of the physiological effects of concussion. They will emphasize the importance of exercise intolerance as a primary indicator of concussion as per the Berlin (2016) consensus conference. They will describe and provide video examples of the best approach to assessment of exercise intolerance.

The presenters will also introduce the concept of cognitive intolerance. They will review the research on cognitive issues following concussion and discuss their own research that utilized functional imaging to demonstrate the inefficiency of the brain in the concussed state. They will describe the developing means of assessing cognitive intolerance and discuss the various approaches used to assist individuals who experience the problem. The issue of cognitive intolerance is especially germane to students with concussion and the presenters will utilize small group discussion with a case example of ‘return to learn’ difficulties associated with cognitive intolerance to illustrate the point.

This preconference workshop will be aimed at all disciplines involved in the assessment and treatment of concussion. It will also be aimed at all potential patient groups from children to adolescents and adults to aging adults. The presenters have experience with (amateur and professional) sports-related concussion, concussion from automobile crashes and concussions related to military action. They will discuss the potential differences in the mechanisms and outcomes of injuries from these different scenarios. Case examples will be used to illustrate the similarities and differences.

The physiological model of concussion places primary responsibility for care on physicians. This symposium will be especially useful for physicians that take a leadership role in the diagnosis and treatment of concussion. The presenters will describe an evidenced-based approach to physical examination that is intended for physicians but may also be utilized by physiotherapists and other health care professionals. Practice of certain aspects of the physical exam will be used to ensure participants can reliably utilize the physical exam elements.

The symposium is designed to be hands on and interactive. While there are didactic components there will also be structured small group assignments based on prepared cases that illustrate a particular aspect of assessment and treatment. Participants will also evaluate cases presented in video format. Participants will be encouraged to add comments or questions throughout the symposium. The presenters are very experienced at presenting this material and have done preconference workshops at ACRM and NABIS with very positive feedback from participants.


  • Identify characteristics of patients with concussion that result directly from changes in their physiology.
  • Understand the importance of assessment of exercise tolerance in patients with concussion and the best means to make that assessment.
  • Develop a treatment plan for patients with concussion that address their problems with exercise intolerance, oculomotor difficulties, cervicogenic issues and vestibular problems.

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