Occupational and Physiotherapy modalities used to support interdisciplinary rehabilitation after concussion: A Scoping Review.

Abstract

To identify and describe occupational and physiotherapy rehabilitation modalities used to support an interdisciplinary rehabilitation in adults (aged 16 + years) with concussion. A scoping review methodology was used. Included studies were categorized according to Wade's elements of rehabilitation and the Danish White Paper definition of rehabilitation. Ten studies were included in this review, addressing: "assessment" (n = 9), "goal-setting" (n = 4), "training" (n = 10), and "social participation and discharge support" (n = 4). Interventions were delivered mainly by physiotherapists or an interdisciplinary team. In two studies occupational therapists were part of the interdisciplinary team. Randomized controlled trials more often addressed several of the rehabilitation elements using interdisciplinary intervention delivery. No studies specifically aimed their intervention at patients with acute or subacute concussion. The therapeutic modalities identified were: (i) manual and sensory motor interventions; (ii) physical exercises; and (iii) management of, or coping with, symptoms. More research is needed on how to better support social participation and discharge or return to work in the rehabilitation process. In addition, interventions delivered in the acute phases of concussion need further exploration.