ON Chiropractic Fall 2014 | Page 20

FEATURE STORY / UNDERSTANDING CONCUSSIONS C oncussions are a growing public health concern, accounting for 70-90% of all traumatic brain injuries (TBI) worldwide.b Although patients with more severe TBIs will likely seek medical attention at a hospital, many patients with mild TBIs (mTBIs) present at other primary health care facilities.D With an incidence of six cases in every 1,000 people, it is likely that most chiropractors will be involved with an mTBI case at some point in their career. The good news is that our understanding of concussions is constantly increasing. Chiropractors can be “ establish and run a residency program for chiropractic students. He worked at the World Health Organization Collaborating Center for Neurotrauma in Sweden to raise over $2 million to fund and operate a task force to deepen research surrounding mTBIs. This task force published the first concussion guidelines in 2004. His work is a cornerstone for public health education and can be found on government websites such as “Concussions Ontario.” Dr. Cassidy currently divides his time between Canada and Denmark where he continues to develop his research and teach at a number of universities. Although the breadth and quality of Athletes who reported three or more concussions were three times as likely to be diagnosed with depression. confident in their knowledge of recovery expectations, their ability to identify high risk patients and their ability to effectively educate patients during the recovery process. Numerous studies show that early education and information given to mTBI patients is beneficial and has positive outcomes on injury resolution.bDs This article highlights current research and patient management by three chiropractors. Dr. David Cassidy D r. David Cassidy has a long and rich history of furthering the chiropractic profession, including the understanding of concussions. During his 35-year career, Dr. Cassidy has published numerous articles and helped to 20 FALL 2014 evidence continues to grow, there is still much that the health care community does not yet fully understand about mTBIs. Dr. Cassidy explains that “we should be concerned about reports that concussions can cause future brain damage, but current studies are not rigorous enough to substantiate this claim. The scientific evidence is weak.” One reason for the gap in current research evidence is due to a focus on short-term effects. Additional long-term research and examinations of the links between repetitive concussions in athletes and late-life neurodegenerative consequences are warranted. A positive correlation between incidence of concussions, late-life depression and other neurological disorders has been suggested in football players and boxers. One study of retired football players found there was a positive correlation between the number of concussions throughout their career and incidence of late-life depression.u From a baseline of football players with no history of concussions, athletes who reported one or two concussions throughout their career were 1.5 times as likely to be diagnosed with depression. Athletes who reported three or more concussions were three times as likely to be diagnosed with depression. While this alerts us to the potential long-term effects of concussions, more research is needed. In a study done on sport concussions with professional football players, most injured athletes recovered to pre-injury levels in terms of cognitive performance within a few weeks. Young athletes need more recovery time than their collegiate or professional counterparts and evidence is being gathered which will aid in understanding concussion prog