UNDERSTANDING CONCUSSION: DIAGNOSIS, TREATMENT & RECOVERY

Activity Description/Need/Practice Gap:

This course provides a background and history of concussion and mild traumatic brain injury treatment, including the pathophysiology of concussion, fundamentals of rehabilitation from brain injury, and information on cognitive rehabilitation. The criteria for diagnosing concussion, an explanation of confounding issues, methods of monitoring recovery, and current recommendations for treatment will be described in detail in order to assist practicing physicians treating and managing patients with the diagnosis of concussion.

The impact of concussion on the developing brain and considerations intricate to treating young children and young athletes diagnosed with concussion, including managing return to school, academics, and cognitive activities will be explained. The importance of documenting concussion recovery in medical records and second impact syndrome will be described. Research topics will also be addressed, including imaging studies, sex and gender issues, treatments and diagnostic techniques. Vestibular and ocular deficits will also be discussed. An overview of the New Jersey Concussion Law will be provided.

Objectives:
At the conclusion of this CME activity, participants should be able to:

The History & Pathophysiology of Concussion - Brian D. Greenwald, MD

1. Describe the pathophysiology of concussion.
2. Explain the differences between the pathophysiology of concussion and more severe TBI.

Neuropsychological Management of Recovery after Cerebral Concussion - Keith D. Cicerone, PhD

1. Discuss the relationship between mTBI and concussion.
2. Explain the role of cognitive rehabilitation in mTBI.
3. Describe potential long-term outcomes of mTBI.

Developing Brain and Second Impact Syndrome – Connie Domingo, MD, FAAP, FAAPM&R

1. Explain the role concussion history has on recovery.
2. Provide 3 reasons for caution when treating the developing brain.
3. Describe the difference between a child with a concussion and an adolescent with a concussion.

Concussion in Youth Sports - David B. Gealt, DO

1. Identify 3 causes of concussion.
2. Describe criteria for diagnosing a concussion.
3. List 5 symptoms of concussion.

Neuropsychological Interventions in Concussion - Jill Brooks, PhD

1. List at least three “red flags” that signal potential complications for recovery.
2. Describe the difference between a baseline neurocognitive test, and a neuropsychological evaluation.
3. Explain the current understanding of return to learn issues.

Vestibular and Ocular Deficits in Concussion – Christine Greiss, DO

1. Identify the different visual deficits that can be encountered in a concussed patient.
2. Identify the most common visual deficits seen in a concussed patient.
3. Identify several ways to evaluate balance deficits in a concussed patient.
4. Perform BESS testing on concussion patient.

Educational Media:
This self-study CME activity consists of six educational multi-media slide presentations with voice-overs from each of the authors. It has been developed as an enduring material through the Office of CME of JFK Medical Center in collaboration with the authors.

Learner Responsibility:
The learner is responsible for the following:

1. Reading the activity description, learning objectives, target audience, disclosure information and viewing the presentations.
2. Completing an on-line evaluation form.
3. Completing an online post-test with a minimum score of 70%. Participants scoring a minimum score of 70% will automatically be issued an electronic certificate of completion.

DISCLOSURE:

In accordance with the ACCME's Standards for Commercial Support of Continuing Medical Education, faculty, planning committee members and reviewers are requested to sign disclosure /attestation of best available evidence statements prior to CME activities.

NO RELEVANT FINANCIAL INTEREST/ARRANGEMENT OR AFFILIATIONS:

The faculty/authors/editorial committee members did not disclose any financial interest or other relationship (i.e. grants, research support, consultant, honoraria) with the manufacturer(s) of any commercial products(s) that may be discussed in the educational presentation and indicated that their talks do not include information on experimental or off-label uses of pharmaceutical products. They are as follows:

Faculty/Authors:

Jill Brooks, PhD, Clinical Neuropsychologist, Head to Head Consultants, P.A., Gladstone, NJ.

Keith Cicerone, PhD, ABPP, FACRM, Director of Neuropsychology and Rehabilitation Psychology, JFK Johnson Rehabilitation Institute and New Jersey Neuroscience Institute, JFK Medical Center; Clinical Director, Cognitive Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ; Clinical Professor of Physical Medicine and Rehabilitation at the University of Medicine and Dentistry of New Jersey and as Associate Professor of Neuroscience, Seton Hall University Graduate School of Medical.

Connie Domingo, MD, FAAP, FAAPMR, Medical Director, Weisman Children’s Rehabilitation Hospital, Marlton, NJ; and Clinical Assistant Professor of Pediatrics, Cooper Medical School of Rowan University, Camden, NJ.

David Gealt, DO, Director of Sports Concussion Program, and Assistant Director, Sports Medicine at Cooper University Health Care, Cherry Hill, NJ; Assistant Professor, Cooper Medical School of Rowan University, Camden, NJ; and Assistant Professor of Rowan University School of Osteopathic Medicine.

Brian Greenwald, MD, Medical Director, Center for Head Injuries, JFK Johnson Rehabilitation Institute; Associate Medical Director, JFK Johnson Rehabilitation Institute, Edison, NJ; and Associate Professor, Physical Medicine and Rehabilitation, RUTGERS-Robert Wood Johnson Medical School, New Brunswick, NJ.

Christine Greiss, DO, FAAPMR, Physiatrist, Stroke Services, Director, The Concussion Program, Physical Medicine and Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ; Asst. Clinical Professor, Physical Medicine and Rehabilitation, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ.

Editorial Committee:

Joanna Boyd, Public Education Coordinator, Brain Injury Alliance of NJ, North Brunswick, NJ.

Carole Kolber, PhD, Adm. Director, Professional Development/CME, (JFKMC) & Clinical Assistant Professor, Health Sciences, Seton Hall University School of Health & Medical Sciences, S. Orange, NJ.

Keith Cicerone, PhD, ABPP, FACRM, Director of Neuropsychology and Rehabilitation Psychology, JFK Johnson Rehabilitation Institute and New Jersey Neuroscience Institute, JFK Medical Center; Clinical Director, Cognitive Rehabilitation, JFK Johnson Rehabilitation Institute, Edison, NJ; Clinical Professor of Physical Medicine and Rehabilitation at the University of Medicine and Dentistry of New Jersey and as Associate Professor of Neuroscience, Seton Hall University Graduate School of Medical.

Brian Greenwald, MD, Medical Director, Center for Head Injuries, JFK Johnson Rehabilitation Institute; Associate Medical Director, JFK Johnson Rehabilitation Institute, Edison, NJ; and Associate Professor, Physical Medicine and Rehabilitation, RUTGERS-Robert Wood Johnson Medical School, New Brunswick, NJ.

Audience:

Family Practitioners, Internists, Pediatricians, Physiatrists, Neurologists, other applicable medical specialties and Nurses.

Accreditation Information:

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of JFK Medical Center and Brain Injury Alliance of New Jersey. JFK Medical Center is accredited by the ACCME to provide continuing medical education for physicians.

Credit: JFK Medical Center designates this enduring material for a maximum of 4.5 AMA PRA Category 1 Credit(s) TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Conflict of Interest/Content Validation: The Office of CME of JFK Medical Center utilizes the following mechanisms to identify and resolve conflicts of interest and validate content: 1) Disclosures by faculty and planning committee of any relationships that might create a potential, apparent or real conflict of interest; 2) Disclosures of off-label drug uses to audience; 3) Participant evaluation of CME activity’s freedom from commercial bias; and 4) Faculty Attestation of best available evidence.

Estimated Time To Complete: 270 minutes (This includes reading the introductory information, viewing the presentations, completing the evaluation form and post-test).

Release Date: November 3, 2017
Termination Date: November 2, 2020