1Strong Evidence: When pt presents with concussive event, the PT should:
• Screen pt and document presence and absence of symptoms related to event
• Screen pt for signs of medical emergency or severe pathology
• Conduct and document a comprehensive medical history
• Screen the pt for mental health/cognitive impairment
2
Strong Evidence: When pt presents with concussive event but have not been diagnosed, the PT should:
• Evaluate for signs and symptoms of concussion
3
Expert opinion: When pt presents with concussive event without symptoms, there is NO SIGNIFICANT EVIDENCE that the PT should
• Evaluate for other diagnoses and follow standard of are procedures for that dx
• Determine whether a PT eval is appropriate based on interview and clinical judgment
4
Expert opinion: When pt is not appropriate for PT due to mental health issues, there is NO SIGNIFICANT EVIDENCE that the PT should
• Educate regarding concussion
5
Strong evidence: When it’s safe for pt to undergo exam, the PT should:
• Determine and document need for PT
6
Strong Evidence: When BPPV is expected, the PT should:
• Perform canalith repositioning maneuvers
7
Strong Evidence: When pt presents with vertiginous symptoms, etc, the PT should
• Examine vestibular/ocular function
8
Strong Evidence: When pt undergoes concussive event, the PT should:
• Test for orthostatic hypotension and autonomic dysfunction
• Examine motor function impairments
9
Strong Evidence: When pt presents with exertional intolerance, dizziness, headache and needs to return to high energy level activities, the PT should:
• Conduct symptom guided exertion testing
10
Strong Evidence:When pt undergoes concussive event and presents with headache, the PT should:
• Determine and document headache type
11
When a pt presents with neck pain, dizziness, fatigue, balance or difficulty with visual focus, there is WEAK EVIDENCE that the PT should:
• Examine C/T spine
12
When pt presents with vestibular/ocular or C spine impairments, there is WEAK EVIDENCE that the PT should:
• Use a stationary bike to test symptom exacerbation
13
When pt does not report exertional intolerance but do report headache, fatigue and fogginess, there is WEAK EVIDENCE that the PT should:
• Assess hypotension and autonomic function, and symptom guided exertional tests
14
Before a pt is examined and reports a concussive event, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Determine levels of irritability to movement and sequence exam based on symptoms
15
When pt undergoes concussive event with high neck pain and no signs of serious pathology, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Examine C/T spine to improve symptoms
16
When pt undergoes concussive event and presents with dizziness, vertigo, headache, there is NO SIGNIFICANT EVIDENCE the PT should:
• Examine for sources of C/T spine dysfunction, vestibular/ocular dysfunction, orthostatic hypotension/autonomic dysfunction
17
Following neck pain, dizziness, headache screening, there is NO SIGNIFICANT EVIDENCE the PT should:
• Continue with multisystem comprehensive exam
18
When a pt does not report symptoms, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Examine C/T spine and TMJ
19
When a pt undergoes concussive event without vestibular/ocular symptoms, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Examine vestibular/ocular function
20
When a pt undergoes concussive event, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Establish and document presence/absence of impairments to support their treatments
21
When PT is evaluating self-efficacy of a pt who underwent a concussive event, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Determine and plan use of an outcome measure that were previously untested
22
When a pt undergoes a concussive event, PT should:
• Educate patient and family on symptoms
• Educate on self management, relative rest, progressive engaged, sleep, safe return to activity
• Refer for consultation of other health care provider if indicated
• Implement a vestibular ocular motor rehab plan
23
When a pt undergoes a concussive event and has movement related impairments, PT should:
• Develop a personalized intervention plan to target pt’s impairments
24
When a pt undergoes a concussive event and has cervical musculoskeletal impairments, PT should:
• Provide interventions for the C and T spine
25
If BPPV is an impairment, the PT should:
• Perform canalith repositioning maneuvers
26
When pt undergoes concussive event and has visual vertigo/visual motion sensitivity, the PT should:
• Provide an individualized visual-motion habituation program
27
When pt undergoes concussive event and exhibits exercise intolerance, the PT should:
• Implement a symptom guided progressive aerobic training program
28
When a pt undergoe a concussive event and is suspected to have motor function impairments, there is WEAK EVIDENCE that the PT should:
• Implement motor function interventions
29
When a pt undergoes a concussive event there is NO SIGNIFICANT EVIDENCE that the PT should:
• Use findings from the exam to triage patients into categories of movement related impairment and those with no movement related impairment
30
When pt undergoes concussive event with vestibular/ocular impairment, there is NO SIGNIFICANT EVIDENCE that the PT should:
• Refer to a clinician with proper expertise if they lack appropriate vestibular/ocular training
31
When pt undergoes concussive event and presents with exertional intolerance, there is NO SIGNIFICANT EVIDENCE the PT should:
• Implement a progressive aerobic training program to reduce risk of deconditioning, promote brain healing and provide nonpharmaceutival option to improve mental health
32
When pt presents with movement related impairments post concussion, there is NO SIGNIFICANT EVIDENCE the PT should:
• Regularly document symptoms, reassess movement related impairments and administer outcome measures