From the Guidelines
Mild traumatic brain injury (mTBI) treatment involves a gradual return to activity, with an initial period of rest followed by gradual increase in physical and cognitive exertion.
Key Components of Treatment
- Initial rest: Patients should be counseled to rest and avoid activities that exacerbate symptoms, especially in the first few days after injury 1.
- Gradual return to activity: As symptoms improve, patients can gradually return to physical and cognitive activities, with the goal of returning to full activity when they are symptom-free at rest and with increasing levels of exertion 1.
- Monitoring and follow-up: Patients should be monitored for postconcussive symptoms and receive clear instructions on how to manage their symptoms, prevent further injury, and return to play or school 1.
- Active management and treatment: For patients with persistent postconcussion symptoms, active management and treatment, including individual disciplines and interdisciplinary rehabilitation, are recommended 1.
Important Considerations
- Prevention of further injury: Patients should be removed from activities that pose a risk of reinjury until they have fully recovered, and should be evaluated by a healthcare professional before returning to contact sports or other high-risk activities 1.
- Recognition of severe symptoms: Patients with severe or worsening symptoms, such as loss of consciousness, severe headache, or altered mental status, should seek immediate medical attention, as these symptoms may indicate a life-threatening brain injury 1.
From the Research
Treatment Overview
The treatment for mild traumatic brain injury (mTBI), also known as a concussion, typically involves:
- Physical and cognitive rest, with a gradual return to activities 2
- An individualized approach that focuses on the affected domains, such as physical, cognition, mood, and sleep 3
- Emphasis on both cognitive and physical rest, with a gradual return to activity, including sports 4
Rehabilitation and Management
Rehabilitation for individuals with mTBI may include:
- Physical therapy management, with a focus on addressing symptoms such as headache, dizziness, nausea, and difficulty concentrating 4
- Vestibular rehabilitation, which can help address injuries to the vestibular and balance system 4
- Neuropsychological evaluation and treatment, which can help manage persisting post-concussive syndrome (PCS) 5
- Neuromodulation treatments, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which have shown promising results for post-concussive symptoms 6
Key Considerations
- Treatment should be tailored to the individual's specific needs and symptoms 3, 4
- Prolonged rest may actually worsen outcomes, and a gradual return to activity is recommended 2
- Symptoms and signs of concussion usually resolve within 10 days, but some individuals may experience protracted symptoms or postconcussion syndrome 2, 4