Multidisciplinary care for patients with persistent symptoms following concussion: a systematic review
Brian Moore, Rachel Keiko Stark, Elisabeth C. D’Angelo
Abstract
Purpose To systematically characterize and assess the effectiveness of multidisciplinary care for patients with persistent post-concussion symptoms (PPCS).Materials and Methods Only studies describing multidisciplinary treatment, defined as intervention provided by no less than 2 healthcare disciplines, each with independent scopes of practice, for patients with PPCS were considered.Results A total of 8 of the 1357 studies identified were included. The studies were comprised of heterogenous patient populations, care delivery systems, healthcare providers, treatment approaches, and outcomes.Conclusions Findings suggest multidisciplinary care, using a needs-based approach with individual- or group-based interventions, may be more beneficial than usual care to; 1) immediately reduce concussion-related symptom complaints and improve mood and quality of life in adolescents following sports-related concussion (SRC) and, 2) may produce immediate and lasting improvements in symptom complaints of young, primarily female, adults following a non-SRC. Future studies should clearly describe the decision-making processes used to deliver care through a needs-based approach and prioritize the inclusion of objective, performance-based measures to assess outcomes.Implications for RehabilitationMultidisciplinary care using a needs-based approach with the individual- and group-based interventions, may be more beneficial than usual care.Younger populations, particularly females, seem to benefit most from multidisciplinary care to decrease the burden of post-concussion symptoms.Multidisciplinary care teams should consider providing psychological support and education combined with cognitive retraining and pharmacologic intervention to address persistent post-concussion symptoms.