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Concussion: Current Concepts in Diagnosis and Management

Borich, Michael R. PT, PhD; Cheung, Katharine L. BS; Jones, Paul BS; Khramova, Vera BA, SC; Gavrailoff, Lauren CAT; Boyd, Lara A. PT, PhD; Virji-Babul, Naznin PT, PhD

Journal of Neurologic Physical Therapy: September 2013 - Volume 37 - Issue 3 - p 133–139
doi: 10.1097/NPT.0b013e31829f7460
Special Interest Articles
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Current understanding of the term “concussion” is fraught with misconceptions regarding the extent and nature of brain injury. Despite increasing attention in popular media and within the context of sports, considerable gaps exist in our knowledge of the diagnosis, underlying brain pathology, recovery of function, and optimal interventions for concussion. In this special interest article, we discuss the definition and risk factors associated with concussion, summarize and highlight some of the most widely used assessment tools, and critique the evidence for current principles of concussion management. Our evaluation has identified opportunities for novel neuroimaging techniques to improve the understanding of the pathophysiology of concussion and to evaluate the changes in the recovering brain in response to rehabilitation. In summary, a clear definition of the underlying brain pathology, the potential long-term consequences, and the risk factors of injury and recovery will help guide future research aiming to minimize the impact of injury and develop innovative and successful therapeutic approaches aimed at ameliorating the functional impairments associated with concussion.

Video Abstract available (see Video, Supplemental Digital Content 1, for more insights from the authors.

Department of Physical Therapy (M.R.B., L.A.B., N.V.B.) and Graduate Program in Neuroscience (K.L.C., P.J., L.G., L.A.B.), University of British Columbia, and Child and Family Research Institute (V.K., N.V.B.), Vancouver, British Columbia, Canada.

Correspondence: Naznin Virji-Babul, PT, PhD, Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada (

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

© 2013 Neurology Section, APTA