Think Head First (THF) is a comprehensive program created to increase overall awareness in the public with respect to mild traumatic brain injury (mTBI), or concussion. THF will also produce a community supported, multidisciplinary management approach for successful recovery.
Our vision is to enhance knowledge and understanding of this common sport injury through education in the hopes of preventing the avoidable incidents, secondly, reducing the likelihood of repetitive injury with the associated consequences of further injury to the brain and possible prolonged symptoms, and most importantly, to prevent second impact syndrome. Second Impact Syndrome refers to a phenomenon where a person sustains a second injury to the brain before the first one is resolved. This syndrome can have devastating effects causing permanent damage to the brain or even death.
Should injury occur, the goal of THF is to provide effective management of the recovery process through an individualized multidisciplinary approach utilizing collaboration / coordination with established resources and professionals in the community to insure best possible outcomes for full recovery and safe return to work, school and sport. This includes integration of the following:
- Medical / Neurological evaluation
- Neurocognitive assessment utilizing ImPACT
- Therapeutic assistance – manual, physical, vestibular/balance, speech, cognitive
- Supervised progressive exertional therapy and reconditioning to re-enter sport
- Psychological support
- Coordination with school counseling for progressive re-entry into educational loads
Improved Awareness is paramount
Concussion is more than just a “bonk” on the head. Any traumatic insult to the body or head can cause disturbance to the normal physiology or function in the brain resulting in signs and symptoms that can range from seemingly mild to severe commonly including; fatigue, increased emotionality, headache/dizziness, confusion, lack of focus, forgetfulness, etc. Increased awareness for unexplained changes in behavior, actions, or thinking following an incident where there may have been traumatic forces transmitted to the brain is critical to recognizing possible concussion early for the best management. Loss of consciousness is not necessary for the diagnosis of concussion, the CDC reported that 90% of diagnosed concussions do NOT involve loss of consciousness.
Concussions are not typically diagnosed by traditional imaging such as CT or MRI scans because the injury disturbance reflects functional alteration rather than structural changes. They are diagnosed based on medical evaluation of signs and symptoms both at the time of incident as well as over the recovery process.
In most cases, recovery from concussion occurs successfully within the first 3 weeks post injury if managed well. In acute injury, the brain is highly vulnerable to prolonged effects or permanent damage if a second insult occurs prior to complete recovery
The best form of treatment for mild traumatic brain injury comes from education to recognize the mild injury and adequate management to avoid re-injury during the recovery process.
Education – at ALL levels
Concussion or mild traumatic brain injury has had quite a bit of recent press regarding the problems with general lack of understanding with this injury. Research in the past 10-15 years has demonstrated the importance of close attention and more conservative approach to management. There are many identified factors leading us to be more aggressive in educating all those involved with sport activities as well as recreational activities and those involved with caring for accident victims to recognize the subtleties in signs and symptoms as well as proper steps to evaluation and collaborative care when injury occurs.
THF focuses on the design of a targeted approach within sport organizations, schools or recreational clubs to create an overall top/down coordinated effort with regard to increased awareness and understanding for prevention, and proper action should injury occur. This involves education at all levels within the organization from board members, administrators, educators, coaches, parents and athletes to appropriate integration of professionals for assistance/guidance in management.
Management of Injury – Multidisciplinary and Integrative
Should injury occur, THF utilizes a multifaceted approach to evaluation and treatment to return the individual to daily activity and sport.
- Medical – medical / neurological evaluation of injury and any physical deficits
- Cognitive assessment – Use of neurocognitive test, ImPACT allows assessment of various brain functions such as memory for words and patterns, focus/concentration, information processing, reaction time and symptoms.
- Neuropsychological / Psychological – some injuries which are more complex or requiring longer recovery will benefit from more extensive neurocognitive assessments and therapy as well as possibly needing psychological support.
- Therapy – recovery from mTBI can be quite complex and require support from various therapeutic specialties for the most efficient, expeditious recovery. THF coordinates support from physical, manual, vestibular, speech, cognitive therapies based on deficits identified.
- School administrators, counselors, teachers, nurses, athletic trainers and coaches – because concussion can result in difficulty in learning, difficulty in focus/concentration, emotional troubles with peers, etc., it is important to have coordinated efforts within the school environment for successful management of the recovery process.