Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management.

Concussion in Combination With Whiplash-Associated Disorder May Be Missed in Primary Care: Key Recommendations for Assessment and Management. J Orthop Sports Phys Ther. 2019 Oct 14;:1-41 Authors: Rebbeck T, Evans K, Elliott JM Abstract SYNOPSIS: Whiplash and concussion may have similar presenting symptoms, biomechanical mechanisms, and neurophysiological sequelae, but neither enjoys a gold standard diagnostic test. Guidelines for whiplash and concussion are developed and implemented separately. This disparate process may contribute to misdiagnosis, delay appropriate primary care management, and impair patient outcomes. In our clinical commentary, we present 3 cases where signs and symptoms consistent with whiplash were identified in primary care. Symptoms in all cases included neck pain, headache, dizziness, and concentration deficits, raising suspicion of coexisting postconcussion syndrome. All cases were referred for specialist physical therapy. Characteristics consistent with poor recovery in both whiplash and postconcussion syndrome were confirmed, and multidisciplinary management, drawing from both whiplash and concussion guidelines, was implemented. All patients reported improvement in activities of daily living after tailored management addressing both neck and head injury-related factors, suggesting that these conditions were not mutually exclusive. Self-reported outcomes included reductions in neck disability and postconcussion symptoms of betwe...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: J Orthop Sports Phys Ther Source Type: research

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