Authors:
Alison Heinekamp, Natalie Molnar, Anne Lennon, Amy Bailes, Jason Hugentobler, Melissa Previtera
Following this course, the learner will be able to:
- Describe the role of occupational therapy in addressing persistent postconcussion symptoms (PPCS) among youth.
- List current interventions to improve occupational performance among youth with PPCS.
- Analyze the strength of evidence supporting different interventions for pediatric mild traumatic brain injury (mTBI) and concussion.
Importance: Persistent postconcussion symptoms (PPCS) may negatively affect youth’s occupational performance in activities of daily living, education, play and leisure, social participation, and rest and sleep.
Objective: This review provides occupational therapists with evidence related to interventions for youth with PPCS.
Data Sources: Searches were performed in Embase, PubMed, SportDiscus, CINAHL, and Web of Science.
Study Selection and Data Collection: Inclusion criteria were as follows: studies published in English from January 1, 2013, to February 7, 2023; youth ages 3 to 18 yr old; PPCS for at least 2 wk after injury; interventions within the scope of occupational therapy; and outcomes related to areas of occupation. All levels of evidence (1–5) were included and graded for quality using the Oxford Centre for Evidence-Based Medicine (2009) levels of evidence. This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.
Findings: Twenty articles met inclusion criteria (7 randomized controlled trials, 1 nonrandomized controlled group design, 3 single-group designs, 5 case series, and 4 single-subject designs). Interventions reviewed were active rehabilitation, vision-related interventions, psychoeducation, cognitive–behavioral therapy (CBT) techniques, the Cognitive Orientation to daily Occupational Performance (CO-OP), and music therapy. Strong evidence supports CBT, with significant clinical outcomes in sleep and education. Moderate strength of evidence supports psychoeducation and active rehabilitation for improving functional outcomes. More evidence is needed to make clinical recommendations regarding vision-related interventions, the CO-OP, and music therapy.
Conclusions and Relevance: Occupational therapists should consider CBT, psychoeducation, and active rehabilitation to improve occupational performance among youth with PPCS.
Plain-Language Summary: Some youth will have persistent symptoms that do not resolve within 2 weeks after a concussion. Because of these persistent symptoms, they may have difficulty completing everyday activities. This review evaluated evidence addressing the ability of youth with persistent postconcussion symptoms (PPCS) to complete everyday activities. The authors found that cognitive–behavioral therapy, psychoeducation (aimed at helping youth understand and cope with their concussion symptoms), and active rehabilitation (aerobic and coordination exercises, such as jumping jacks and ball skills) should be considered when working with youth (ages 3–18 years) with PPCS. Using these interventions in occupational therapy sessions may improve the ability of youth to complete their everyday activities after a concussion.
Heinekamp, A., Molnar, N., Lennon, A., Bailes, A., Hugentobler, J., & Previtera, M. (2024). Interventions to improve the occupational performance of youth with persistent postconcussion symptoms: A systematic review. American Journal of Occupational Therapy, 78, 7806205060. https:// doi.org/10.5014/ajot.2024.050642
Expiration: Please note that all AOTA CE courses expire at one year from date of purchase.