Have you ever had a patient after a head knock complain of dizziness, imbalance, foggy thoughts, fatigue and difficulty focusing or functioning? There is strong evidence that mild brain injuries and concussion can leave a patient moving 'normally' but functioning 'poorly'. This is a challenging diagnosis as there is currently no assessment tool available that can indetify a person with suboptimal integration post head knock.
Recent recommendations have clearly outlined guidelines for the diagnosis of concussions and the roles of each health team member (McCrory et al 2017). There is also high level evidence that vestibular rehabilitation has positive benefits to person post concussion complaining of dizziness (Murray et al 2017). The gaps in evidence lay in the ability of any one single test to diagnosis concussion and the optimal dose and type of exercises beneficial for people with post-concussion disorder. It is not surprising the one test is elusive to find in the diagnosis of this population. The role of the brains integrative skill is paramount in the identification of concussion. The individuality of the person and injury will play heavily on how the brain may respond, not speaking of any associated peripheral injuries. Similarly due to the diversity and individuality of a concussed persons injury treatment regimes need to be individualised its clear and precise assessments utilised to guide treatment development and review. Read more to fully appreciate the complexity of the brain and the subtle presentation of a concussion.