Concussions took center stage at a symposium this spring presented by the University of Kansas Medical Center and The University of Kansas Health System. The inaugural Current Concepts in Concussion Management: Team-Based Interventions symposium helped expand the knowledge base of practitioners across the region who treat concussion.

Featuring KU experts from neurology, neurosurgery, physical medicine and rehabilitation, psychiatry and behavioral sciences, and family medicine, as well as a local optometrist, the day-long event at the Health Education Building on the KU Medical Center campus in Kansas City drew nearly 250 registered participants, including physicians, athletics trainers, nurses, EMS personnel, therapists and other practitioners.

The goal of the symposium was to share evidence-based expertise on treating concussion and to highlight the importance of taking a multidisciplinary, team-based approach to caring for patients with concussion.

"We created the symposium to reach out to other practitioners in the area who are seeing concussion, but may not have the background or expertise to treat it," said Michael A. Rippee, M.D., assistant professor of neurology at KU Medical Center and medical director for the Center for Concussion Management at The University of Kansas Health System. "There also are rapidly changing guidelines based on new research that's not always communicated to the wide variety of health professionals involved in the care of these patients."

Concussion, simply defined, is a violent shaking of the brain. Though often linked to playing sports, concussions can be sustained in other ways such as falls, vehicular accidents or being struck with an object. In fact, according to data from The University of Kansas Health System Center for Concussion Management, 46% of patients treated for concussion there sustained the injury through nonsports-related activities.

Concussions are treatable. The majority of these injuries heal within 21 to 28 days, although in about 5% of cases, patients experience post-concussion syndrome, when the symptoms last more than three months after an injury occurs.

"We have a very good idea of what happens at a cellular level after an injury. What is not as well known is how that may affect a person," Rippee said. "We have to recognize that not every head impact is sufficient to cause enough injury to cause concussion. We also have to realize that not every symptom after a head injury is always related to a concussion."

Symposium topics provided practitioners with a mix of tools and insights useful in diagnosing and managing concussion as well as different potential treatment approaches such as physical, occupational, speech and vestibular therapies along with managing mood-related symptoms.

"Every concussion is different and every person exposed to injury is different, creating a complex diagnostic environment," Rippee said. "We really know very little about the long-term effects of concussion. CTE, Chronic Traumatic Encephalopathy, is a popular media topic at this time, but the science is in the very early stages at this point and the link is not completely elucidated."

Presenters also delved into the latest research on concussion, which continues to evolve at a rapid pace. For instance, key findings in recent years suggest prolonged rest immediately after a concussion may make symptoms worse. As a result, practitioners now prescribe brief periods of rest for the first 24 to 72 hours before attempting a gradual return to activity.

Though research into biomarkers and other diagnostic tools is promising, according to a 2019 study, right now the two most sensitive tools for determining concussion are a symptom report and a vestibular-ocular exam, a 5- to 10-minute test that assesses balance and vision.

Although there is currently no effective way to prevent concussion, a lot of effort is being poured into developing equipment such as helmets and mouth guards with sensor technology that could, for instance, detect impact or monitor a wearer's vital signs.

"There is a lot of research going into prevention with equipment, but more important is reduction of risk by decreasing exposure, say less contact in practice, for instance, and teaching proper techniques," Rippee said.

Symposium presenters from KU included Rippee; William Condon, Jr., PT, MT; Maria Davenport, PT, MPT; Martin Delphino, PT, DPT; Jamie Johnson, MA, L/CCC-SLP, BCS-S; Monica Kurylo, Ph.D, ABPP; Claude Lamoureux, PT, DPT, NCS; Alexandrea Neilsen Arickx, M.D.; David M. Smith, M.D., FAAP; and Lisa Vopat, M.D.

Local speaker Ashley S. Reddell, O.D., FCOVD, is an optometrist and owner of Family EyeCare Center in Leavenworth.

The KU Medical Center has multiple active and ongoing research studies through The University of Kansas Health System, such as stationary bike exertion protocol after concussion, hearing and speech clinical assessment of auditory damage following concussion and driving habits of concussion patients.