Improvement in Symptoms and Cognitive Measurements in a High School Hockey Player with Protracted Concussion Symptoms
Background: An 18 year old, high school, male hockey player, with a history of 7 documented concussions, presented with symptoms of headache, “brain fog”, and sluggishness. Graded Symptom Checklist (GSC) severity was a 14/138. Standard Assessment of Cognition (SAC) was scored at 21/30. Trails A (TA) and Trails B (TB) had scores of 22.3 sec and 51.8 seconds respectively; Trails AB Difference (TB-A) was 29.5 sec. Processing Speed (PS) score was a 52/80. Choice Reaction Time (cRT) latency was 462 milliseconds.
Methods: A four-day, multi-modal program of neurological rehabilitation was administered three times per day, for one hour per session. Each session consisted of electrical somatosensory stimulation, neuromuscular reeducation exercises, vestibular rehabilitation exercises, off-vertical axis rotation, and eye exercises.
Results: At the end of four days of treatment there was complete resolution of symptoms; GSC severity (-100%). The patient had an increased SAC score (+28.6%), decreased TA time (-19.3%), decreased TB time (-25.3%), TB-A decreased (-29.8%), increased PS score (+21.2%), and decreased cRT latency (-21.2%).
Conclusion: Short duration, multi-modal, intensive programs of neurological rehabilitation may be a viable method to improve neurological integrity and performance in individuals with protracted concussive deficits. The authors suggest further investigation into short duration, multi-modal, intensive approaches to restoring neurological function in individuals suffering from mild traumatic brain injury (mTBI)