Concussion is a common injury in youth. Studies report that active rehabilitation interventions reduce symptoms in these youth. There is no literature that addresses its impact on occupational performance. The purpose of this study was to identify: (a) occupational performance issues experienced by these youth; (b) changes in occupational performance and satisfaction following participation in a 6-week active rehabilitation intervention; and (c) the relationship between changes in occupational performance and symptoms.
Method
As part of a larger prospective repeated measures study, measures of occupational performance (Canadian Occupational Performance Measure) and self-reported symptoms (Post-Concussion Symptom Inventory) were collected pre and post intervention. Paired t-test, Spearman correlation, and descriptive analyses were conducted.
Results
Youth (9–18 years; n = 52) reported a range of occupational performance issues in self-care, productivity, and leisure domains. The most frequently reported occupational performance issues were sport (32.70%) and school (31.75%) activities. Positive changes were found in both performance and satisfaction of occupational performance issues post intervention (p<.001). Correlation analysis revealed that as symptoms decreased, occupational performance improved (rs = –.359, p = .020).
Conclusion
Using a measure of occupational performance may provide meaningful insight into the functional recovery of concussion, and can help identify targeted functional approaches to paediatric concussion management.
BarlowKMCrawfordSStevensonA, et al. (2010)
Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury.Pediatrics126(20): e374–e381.
2.
CarswellAMcCollMABaptisteS, et al. (2004)
The Canadian Occupational Performance Measure: A research and clinical literature review.Canadian Journal of Occupational Therapy71(4): 210–222.
3.
DaneshvarMARileyDONowinskiCJ, et al. (2011)
Long term consequences: Effects on normal development profile after concussion.Physical Rehabilitation & Medical Clinics of North America22(4): 683–700.
4.
DobneyDMGrilliLKocilowiczH, et al. (2017)
Evaluation of an active rehabilitation program for concussion management in children and adolescents.Brain Injury31(13–14): 1753–1759.
5.
DykemanB (2003)
School-based interventions for treating social adjustment difficulties in children with traumatic brain injury. Journal of Instructional Psychology30(3): 225–230.
6.
GagnonIGalliCFriedmanD, et al. (2009)
Active rehabilitation for children who are slow to recover following sport-related concussion.Brain Injury23(12): 956–964.
7.
GagnonIGrilliLFriedmanD (2015)
A pilot study of active rehabilitation for adolescents who are slow to recover from sport-related concussion.Scandinavian Journal of Medicine & Science in Sports23(3): 299–306.
8.
GioiaGACollinsMIsquithPK (2008)
Improving identification and diagnosis of mild traumatic brain injury with evidence: Psychometric support for the acute concussion evaluation.Journal of Head Trauma Rehabilitation23(4): 230–242.
9.
GriesbachGSHovdaDAMolteniR, et al. (2004)
Voluntary exercise following traumatic brain injury: Brain-derived neurotrophic factor upregulation and recovery of function.Neuroscience Letters125(1): 129–139.
10.
GroolAMAglipayMMomoliF, et al. (2016)
Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents.Journal of American Medical Association316(23): 2504–2514.
11.
HuntADe FeoLMacintyreJ, et al. (2016)
Development and feasibility of an evidence-informed self-management education program in pediatric concussion rehabilitation.BMC Health Services Research16(1): 1–8.
12.
HuntAPanicciaMMahK, et al. (2019)
Feasibility and effects of the CO-OP approach in postconcussion rehabilitation.The American Journal of Occupational Therapy73(1): 7301205060p1–7301205060p11.
ImhoffSFaitPCarrier-ToutantF, et al. (2016)
Efficiency of an active rehabilitation intervention in a slow-to-recover paediatric population following mild traumatic brain injury: A pilot study.Journal of Sports Medicine2016: 1–11. DOI: 10.1155/2016/5127374.
15.
IversonGLGardnerAJTerryDP, et al. (2017)
Predictors of clinical recovery from concussion: A systematic review.British Journal of Sports Medicine51(12): 941–948.
16.
KurowskiBGHugentoblerJQuatman-YatesC, et al. (2017)
Aerobic exercise for adolescents with prolonged symptoms after mild traumatic brain injury: An exploratory randomized clinical trial.Journal of Head Trauma Rehabilitation32(2): 79–89.
17.
LawMBaptisteSCarswellA, et al. (1998) Canadian Occupational Performance Measure.
Toronto, ON:
CAOT Publications ACE.
18.
LawrenceDWRichardsDComperP, et al. (2018)
Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion. PLoS ONE13(4): 1–12.
19.
McCollMACarswellALawM, et al. (2006) Research on the Canadian Occupational Performance Measure: An Annotated Resource.
Ottawa, ON:
Canadian Association of Occupational Therapists.
20.
McCroryPMeeuwisseWDvorakJ, et al. (2017)
Consensus statement on concussion in sport – The 5th international conference on concussion in sport held in Berlin, October 2016.British Journal of Sports Medicine51(11): 838–847.
21.
McDougallJWrightV (2009)
The ICF-CY and Goal Attainment Scaling: Benefits of their combined use for pediatric practice.Disability and Rehabilitation31(16): 1362–1372.
22.
MallerJJThomsonRHSLewisPM, et al. (2010)
Traumatic brain injury, major depression, and diffusion tensor imaging: Making connections.Brain Research Reviews64(1): 213–240.
23.
MentoAJLockeEAKleinHJ (1992)
Relationship of goal level to valence and instrumentality.Journal of Applied Psychology77(4): 395–405.
24.
MissiunaCDeMatteoCHannaS, et al. (2010)
Exploring the use of cognitive intervention for children with acquired brain injury.Physical and Occupational Therapy in Pediatrics30(3): 205–219.
25.
ØienIFallangBØstensjøS (2009)
Goal-setting in paediatric rehabilitation: Perceptions of parents and professional.Child: Care, Health and Development36(4): 558–565.
ØstensjøSØienIFallangB (2008)
Goal-oriented rehabilitation of preschoolers with cerebral palsy – A multi-case study of combined use of the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scaling (GAS).Developmental Neurorehabilitation11(4): 252–259.
28.
PanicciaMJReedNP (2017)
Dove and hawk profiles in youth concussion: Rethinking occupational performance.Canadian Journal of Occupational Therapy84(2): 111–118.
29.
PortneyLGWatkinsMP (2015) Foundations of Clinical Research: Applications to Practice, 3rd ednPhiladelphia, PA:
F. A. Davis Company.
30.
RansomDVaughanCPratsonL, et al. (2015)
Academic effects of concussion in children and adolescents.Pediatrics135(6): 1043–1050.
31.
ReedNGreenspoonDIversonGL, et al. (2015)
Management of persistent postconcussion symptoms in youth: A randomised control trial protocol. BMJ Open5(7): 1–8.
32.
SadyMDVaughanCGGioiaG (2014)
Psychometric characteristics of the postconcussion symptom inventory in children and adolescents.Archives of Clinical Neuropsychology29(4): 348–363.
33.
ThomasDGAppsJNHoffmannRG, et al. (2015)
Benefits of strict rest after acute concussion: A randomized controlled trial.Pediatrics135(2): 213–223.
34.
ZemekRBarrowmanNFreedmanSB, et al. (2016)
Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED.Journal of American Medical Association315(10): 1014–1025.
