Concussion represents a mild traumatic brain injury caused by rapid acceleration, deceleration, and rotational forces. This causes stretching of the neural structures and ultimately altering the brain’s function. However, the brain has a good capacity to recover from knocks to the head with 80% of concussions resolving in 7-14 days. In post-concussion syndrome, symptoms persist longer than would be expected from the nature of the injury. What happens is that after experiencing a concussion, 'volume knobs' in pathways in the nervous system become 'turned up'. These include pain pathways as well as sensory pathways which are involved in symptoms like dizziness. After a bang to the head this process can be altered leading to inaccurate pain signals and sensory signals getting through.Normally those 'volume knobs' get turned down again and the 'brain filters' are restored as you slowly recover. However, in post-concussion syndrome they stay turned up, or even become increased further over time.
The symptoms of Post-Concussion Syndrome include:
Visual disturbances included blurred vision, double vision, and sensitivity to complex visual environments such as supermarket aisles. Visual Disturbances are common with post-concussion syndrome and can have a profound effect on our ability to do our usual activities and go to work, causing significant psychological distress. Visual field deficits may also present a safety hazard as poor spatial awareness and depth perception can increase the risk of tripping, bumping into objects and falling.
Through a comprehensive history and a series of objective tests to determine onset of symptoms, progression over time, aggravating factors, and to assess the deficits of the vestibular system. The objective tests include dynamic balance, oculomotor tests, dynamic visual acuity testing, as well as positional testing to rule out other vestibular disorders.
Based on findings from the exam, patients undergo a treatment technique called habitualisation. These consist of a specific series of exercises used to recalibrated the bodies balance system and to improve it. Your physiotherapist will also provide you with specific exercises to restore the balance to the vestibular system so that your sense of orientation and the stability of your vision particularly when moving your head improves and you feel more confident in your balance. Following each session, your physiotherapist will provide a structured program with exercises to complete at home.
After the Session:
Your physiotherapist will provide a structured program with exercises to complete at home. Physiotherapy has been shown to help manage the symptoms of post-concussion syndrome. On average patients will find significant decreases in their symptoms in two to three sessions.