Summarized by Dr. Jessie Chan
November 2023

A recent article titled, “Rehabilitation of Social Communication Skills in Patients with Acquired Brain Injury with Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial” was published in the Archives of Physical Medicine and Rehabilitation by authors Ingebresten et al. People with brain injuries often have trouble with social communication, which makes it hard for them to fit back into their community. This can lead to loneliness and difficulty with making friends or finding and keeping a job.

Past studies showed that a treatment done once a week for 3 months can help people with acquired brain injuries communicate better and feel happier in their day-to-day lives. The treatment includes group activities, help with setting personal goals, homework, and active feedback. It helps with parts of communication like understanding what other people are thinking and not saying inappropriate things. There is not a lot of information on how long or often treatments should be, so the authors did an earlier study to test how well the same treatment done every day for one month would help patients. It showed that this shortened and frequent treatment worked about as well as the original treatment.

This study compared two groups of people in Norway who had acquired traumatic or nontraumatic brain injuries. Group A got standard treatment which was once a week for 3 months in an outpatient clinic. Group B was first put on a waitlist without treatment for social communication for 9 months. This created a “no treatment” group to compare against. Group B then had intensive treatment which was every day for one month in an inpatient cognitive rehabilitation unit. This group of patients were encouraged to go home on weekends during treatment to practice their skills in real life with friends and family. The results showed that both the standard and intensive treatments helped people with brain injuries communicate better compared to no treatment. At the end of the study, Group A and Group B had equal improvements in social communication skills, even when they were retested 6 months later.

It seems that standard outpatient and intensive inpatient social communication treatment are both good options for people with acquired injuries to communicate better. One factor to think about is that intensive inpatient treatment can be harder to find, but it could be a good option for people who have fewer friends and family to practice social skills with or would have trouble getting to the outpatient clinic every week. This study shows that both kinds of treatments can help acquired brain injury patients with improving social communication, even if it has been a long time since the injury happened.

For more information read the entire article https://pubmed.ncbi.nlm.nih.gov/36966953/

Summarized by Arielle Berkowitz, DO
November 2023

When a player experiences a bump to the head during a sports game or practice, he/she may begin to experience headaches, dizziness, blurred vision, trouble concentrating, or a brief loss of consciousness known as a Sports Related Concussion (SRC). These symptoms are often troubling and may make it difficult to immediately return to school, work, and/or sports. SRC can occur at any age and at any level of athletic training.

Recovery after a SRC is different for each individual. Athletes who are female, who have had prior concussions, learning disabilities, and/or psychiatric illness may have more trouble returning to their normal daily activities. During this tough time, it is important to follow with experts who can help with the recovery process and provide education, guidance, and encouragement.

In the past, it was recommended that athletes who have sustained a SRC completely rest their minds and body- avoiding television, phones, computers, and school-work- so that their brains could fully heal. More recent guidelines advise light activity/work during this recovery period. In most states, athletes are required to progress through a daily exercise schedule with a trained professional for one whole week. During this time, the athlete must perform exercises with increasing intensity with close monitoring of symptoms.

Vestibular therapy is a therapy that is often offered to patients who continue to experience symptoms such as dizziness and balance issues weeks after their injury. With vestibular therapy, patients work closely with physical therapists to improve things such as balance and vision. In a recent article, “Early Initiation of Vestibular Therapy Following Sport-Related Concussions: A Retrospective Cohort Study,” by Ferry et al., the authors wanted to determine whether or not starting vestibular therapy shortly after injury would result in a faster recovery. In this study, the researchers reviewed the medical charts of patients ages 12-25 years who had a SRC between January 2014-December 2019, were seen in the Sports Medicine Concussion Clinic at Duke University and were referred to PT for vestibular therapy.

Results from this study suggested that waiting to start vestibular therapy could increase the time to recovery and return to sport. In other words, starting vestibular therapy early after injury could result in a quicker recovery. After SRC, it is important to seek appropriate care early. Although we still need more details regarding exactly how long a person should receive vestibular therapy, how frequently he/she should go for visits, and when to begin the therapy, it is noted that, overall, it is extremely helpful without any detrimental effects.

For more information view the article https://doi.org/10.7759/cureus.39764