One size fits none: neurobiologic-specific modifications for the assessment, diagnosis, and treatment of sport-related concussion (SRC)

ABSTRACT

Primary objective

– To discuss how the underlying neuroanatomy and neurobiology of five sport-related concussion (SRC) clinical profiles impacts assessment and treatment.

Research design

– Narrative review.

Methods and procedures

– Based on the current literature and clinical experience, arguments against the traditional SRC protocol and for a clinical profiles-based SRC protocol are made.

Main outcomes and results

– While the clinical profiles-based SRC protocol is widely used and accepted, there has been little published regarding the link to the underlying neuropathology. Our narrative review describes the five SRC clinical profiles: vestibular, ocular, mood, post-traumatic migraine, and cognitive/fatigue. For these profiles, the underlying neuroanatomy and neurobiology is outlined, as well as how that anatomy and biology impact the profiles’ etiology, assessment, and treatment. The cervical and sleep modifiers are also briefly covered.

Conclusions

– Utilizing this model, clinicians are able to provide an individualized assessment, conceptualization, and treatment plan for SRC, leading to improved outcomes and clinical experiences for athletes.

KEYWORDS:

• sport-related concussion (SRC)
• clinical profiles
• Vestibular/Ocular Motor Screening (VOMS)
• Physical Exertion Rehabilitation

Disclosure of Interest

The authors report no conflict of interest.