Objective: To evaluate the effectiveness of an individualized multidisciplinary rehabilitation program for treating individuals with persistent post-concussive symptoms (PPCS), and identify initial symptoms which predict overall symptom burden after rehabilitation. Design: This retrospective cohort study employed routine assessment data from the Epworth HealthCare Rehabilitation Concussion Clinic. Patients with PPCS (n=528) participated in an individualized outpatient rehabilitation program, and self-reported symptoms and activity levels (using the Oregon Post-Concussion Symptom Checklist) on clinic admission and discharge. Summed checklist scores produced four subscale scores (physical, thinking, emotional and sleep) and a total score. Results: On Clinic admission, patients self-reported a mean of 10.9 symptoms (SD: 6.0). Fatigue, cognitive impairments and headache were common. There was a statistically significant mean decrease in checklist scores (symptom burden) after rehabilitation ( P =<0.001). Patients’ mean daily activity levels also significantly increased between clinic admission (43.1%) and discharge (73.9%) (mean difference: 30.8%, 95% CI: 28.2-33.5, P =<.001). A subset of somatic and vestibular-ocular symptoms cumulatively predicted 31.1% of the total variance in symptom burden on clinic discharge. Conclusion: This study suggested that a multidisciplinary rehabilitation model was effective for treating PPCS. A focus should be on early, tailored intervention to moderate the initial symptom burden and improve patient prognosis.
Olver et al. (Thu,) studied this question.
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