ArticleBiomedical engineering online2025
Complexity of post-concussion syndrome assessment and management: a case for customizing rehabilitation.
Article in Biomedical engineering online, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Effectiveness of a Customized Rehabilitation Program for Adults With Post-Concussion Syndrome-A Randomized Controlled Crossover Trial.The Journal of head trauma rehabilitationTrial
- The role of occupational therapy in the rehabilitation of adults with persistent post-concussion symptoms in Australia and New Zealand: A qualitative study.Australian occupational therapy journal · 2026Article
- Physiological Outcomes of Physical Activity Interventions in Persistent Postconcussive Symptoms: A Scoping Review.Sports medicine (Auckland, N.Z.) · 2026Article
- Special collection in association with the 2024 International Conference on Aging, Innovation and Rehabilitation.Biomedical engineering online · 2025Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPost-concussion syndrome is a challenging condition to manage for even the most experienced chronic pain experts. Patients' presentations are heterogeneous with symptoms spanning physical, cognitive and emotional domains. The symptoms reported are often non-specific, making it difficult for health professionals to prescribe effective rehabilitation. The aim of the present study was to examine the effectiveness of a customized rehabilitation program based on subgroup determination following a standardized clinical exam in adults with post-concussion syndrome.
methodsA total of 16 adults (mean age ± SD, 38.3 ± 12.5 years) with post-concussion syndrome participated in a 6-week rehabilitation program. Participants were recruited from external community concussion clinics around the greater Toronto area, Canada. Participants underwent a comprehensive standardized clinical exam to subgroup the ostensible symptom generators into either autonomic, cervical or vestibulo-ocular. Customized rehabilitation was then prescribed based on their subgroupings. The primary outcome measure was the Rivermead Post-Concussion Questionnaire (RPQ). Secondary outcome measures included the Patient Health Questionnaire-9 (PHQ-9), the Neck Disability Index (NDI), and exercise tolerance as assessed via the Buffalo Concussion Treadmill Test (BCTT).
resultsFollowing 6 weeks of customized rehabilitation, participants on average experienced a significant and clinically meaningful change with respect to the RPQ-3 and RPQ-13 (p < 0.001). We also observed a significant change in all secondary outcome measures including a reduction in PHQ-9 (p < 0.01), NDI (p < 0.001) and exercise tolerance, expressed as heart rate threshold (p < 0.001).
conclusionThe standardized exam was feasible and useful in assisting the clinician in prescribing effective rehabilitation. The 6-week customized rehabilitation program demonstrated significant changes in patient-reported persistent post-concussion symptoms and exercise tolerance. The implementation of a customized program based on a standardized exam performed to subgroup the ostensible symptom generators may be key to successful management in this population.
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