0.94 CME

Réadaptation dans la gestion des commotions cérébrales sportives

Conférencier: Dr Vaishali Goyal

Fondateur et directeur général du centre de physiothérapie et de réadaptation Pro Cure

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Description

Rehabilitation in sports concussion management is a crucial aspect that focuses on a gradual and individualized return to physical and cognitive activities. This process involves a stepwise progression, closely monitored by healthcare professionals, aiming to ensure the athlete's complete recovery, minimize the risk of recurrent concussions, and address any lingering symptoms through targeted therapies and neuromuscular training. Comprehensive rehabilitation not only facilitates the return to sport but also prioritizes the long-term well-being of the athlete by addressing physical, cognitive, and emotional aspects of recovery.

In sports concussion rehabilitation, the initial phase often involves cognitive rest and symptom management, allowing the brain to heal. As symptoms improve, a structured rehabilitation program integrates gradual exertion, balance exercises, and sport-specific drills to assess and enhance physical and cognitive capabilities. Collaborative efforts between healthcare providers, athletic trainers, and the athlete are essential in tailoring the rehabilitation plan to individual needs and ensuring a safe and effective return to play. Emphasizing education on injury prevention, proper technique, and ongoing monitoring further contributes to the holistic approach of sports concussion rehabilitation, prioritizing both short-term recovery and the athlete's long-term health

Résumé

  • Sports concussion is a traumatic brain injury induced by biomechanical forces, often during sports, leading to transient neurological impairment. It's more common in contact sports like football, and recognizing a history of concussion is crucial to prevent long-term consequences.
  • Physiotherapy plays a key role in sports concussion management by promoting recovery, reducing symptoms, and preventing re-occurrence. Interventions address specific impairments like vestibular dysfunction and coordination issues, guiding athletes through stepwise return-to-play protocols.
  • The pathophysiology of sports concussion involves rapid brain movement within the skull, leading to stretching and deformation of neural structures. This triggers a cascade of events like altered neurotransmitter release and ion channel function, disrupting neural networks.
  • Assessment and diagnosis involve clinical history, symptom evaluation (cognition, vestibular impairment, memory loss), cognitive assessment, balance/vestibular assessment (cranial nerve testing, static/dynamic balance tests), visual assessment, and physical examination.
  • Rehabilitation strategies are phased. Early interventions involve rest, activity modification, vestibular/balance training, visual/ocular motor exercises, and cervical spine rehabilitation. Mid-stage includes controlled clinic training (kicking, ladder drills), aerobic exercise, and cognitive rehabilitation.
  • Late-stage rehabilitation focuses on sport-specific drills and plyometrics, progressive training and performance enhancement, psychological support, and return-to-sport decision-making. Neurological clearance is essential before the athlete returns to play.
  • Monitoring and follow-up are crucial even after returning to play. Regular follow-ups with the physiotherapist help track symptoms, cognitive function, balance, and vestibular performance. Adjustments to the rehabilitation plan are made based on the individual's progress.
  • Future directions in sports concussion rehabilitation emphasize addressing physical, cognitive, and vestibular impairments. Graded protocols and multidisciplinary collaboration ensure a safe and gradual return to sports, minimizing the risk of secondary injuries and persistent symptoms.
  • Managing sleep disturbances, neck strengthening exercises, dual task exercises, proprioceptive training, and adapting rehabilitation exercises for athletes with preexisting conditions are key aspects of concussion rehabilitation.

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