Abstract
CME Educational Objectives 1. Identify the time frame that distinguishes concussion with typical recovery trajectory vs. atypical prolonged recovery trajectory. 2. Use directed physical examination to identify deficits that may be addressed by targeted rehabilitation strategies. 3. Implement exercise strategies in the rehabilitation of concussion with atypical prolonged recovery outside of the typical return-to-play protocol. Most pediatric and adolescent concussion patients will heal within 1 month. However, 10% to 20% of adolescent concussions will take longer than 1 month to heal. In this subgroup, prolonged symptoms might include vestibular system deficits, residual neck muscle whiplash injury, exercise intolerance/dysautonomia, and memory issues. At this stage in recovery, these problems respond better to “active rehabilitation” via specific targeted strategies rather than to strict rest. During follow-up office visits, a careful history and physical exam can elicit specific deficits and help customize a rehabilitation program to maximize recovery.
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