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  1. Article ; Online: Osteopathic manipulative treatment for concussions and postconcussive syndrome in athletes: a literature review.

    Thomas, Kevin D / Lombard, Zoe K / Shadiack, Anthony L

    Journal of osteopathic medicine

    2023  Volume 123, Issue 8, Page(s) 395–403

    Abstract: Context: Concussions are the most common type of traumatic brain injury (TBI) and can often occur in athletes. These injuries have many deleterious acute symptoms and can lead to the development of postconcussive syndrome (PCS). Osteopathic manipulative ...

    Abstract Context: Concussions are the most common type of traumatic brain injury (TBI) and can often occur in athletes. These injuries have many deleterious acute symptoms and can lead to the development of postconcussive syndrome (PCS). Osteopathic manipulative treatment (OMT) is a treatment option that may benefit patients with concussions and PCS.
    Objectives: The objective of this review is to determine whether OMT can improve symptoms associated with concussions and PCS in athletes.
    Methods: A comprehensive literature review was conducted between August 2021 and March 2022 by two authors (Z.K.L. and K.D.T.) who searched the literature utilizing PubMed, Google Scholar, and Cochrane Library. Articles reviewed included case reports, case studies, randomized control trials, meta-analyses, and peer-reviewed journal articles. Search terms included concussion, postconcussive symptoms, osteopathic manipulative medicine, and manipulation. To be included into this study, articles must have included OMT from an osteopathic physician or manipulative techniques by nonosteopathic providers for patients with a concussion or PCS, and the insulting injury must have occurred in an athletic setting. No disagreements occurred between authors about what studies to include. However, we were prepared to come to a unanimous decision through discussion among the authors. A narrative synthesis was performed. No other data analyses were conducted in this study.
    Results: Included in this review were nine articles including randomized control trials, retrospective review, case series, longitudinal, retrospective studies, and case reports. The literature shows the positive effects of OMT and manipulative techniques on symptom resolution after a concussion. However, most of the literature is qualitative rather than quantitative in nature, lacking in randomized control trials.
    Conclusions: There is a scarcity of high-quality studies evaluating the effectiveness of OMT on concussions and PCS. More research is needed to understand the degree of benefit for this treatment option.
    MeSH term(s) Humans ; Manipulation, Osteopathic/methods ; Retrospective Studies ; Brain Concussion/complications ; Brain Concussion/therapy ; Brain Concussion/diagnosis ; Osteopathic Medicine ; Athletes
    Language English
    Publishing date 2023-06-07
    Publishing country Germany
    Document type Journal Article ; Review
    ISSN 2702-3648
    ISSN (online) 2702-3648
    DOI 10.1515/jom-2022-0217
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Predicting Complicated Mild Traumatic Brain Injury in Adolescent Trauma to Enhance Clinical Decisions in Imaging.

    Rhodes, Heather X / Berg, Gina / Shadiack, Anthony L / Thomas, Kevin D / Horawski, Jennifer L / Boyer, Geoff / Kleist, Sara M / Worthley, Aaron I / Rosenberg, David I / Gutovitz, Scott B / Helmrich, George A / Biswas, Saptarshi / Pepe, Antonio P

    Journal of trauma nursing : the official journal of the Society of Trauma Nurses

    2023  Volume 30, Issue 3, Page(s) 150–157

    Abstract: Background: The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury algorithm is used to identify children at low risk of clinically significant traumatic brain injuries to reduce computed tomography (CT) exposure. Adapting ...

    Abstract Background: The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury algorithm is used to identify children at low risk of clinically significant traumatic brain injuries to reduce computed tomography (CT) exposure. Adapting PECARN rules based on population-specific risk stratification has been suggested to improve diagnostic accuracy.
    Objective: This study sought to identify center-specific patient variables, beyond PECARN rules, that may enhance the identification of patients requiring neuroimaging.
    Methods: This single-center, retrospective cohort study was conducted from July 1, 2016, to July 1, 2020, in a Southwestern U.S. Level II pediatric trauma center. The inclusion criteria were adolescents (10-15 years), Glasgow Coma Scale (13-15), with a confirmed mechanical blow to the head. Patients without a head CT were excluded. Logistic regression was performed to identify additional complicated mild traumatic brain injury predictor variables beyond the PECARN.
    Results: There were 136 patients studied; 21 (15%) presented with a complicated mild traumatic brain injury. Relative to motorcycle collision or all-terrain vehicle trauma (odds ratio [OR] 211.75, 95% confidence interval, CI [4.51, 9931.41], p < .001), an unspecified mechanism (OR 42.0, 95% CI [1.30, 1350.97], p = .03) and consult activation (OR 17.44, 95% CI [1.75, 173.31], p = .01) were significantly associated with complicated mild traumatic brain injury.
    Conclusions: We identified additional factors associated with complex mild traumatic brain injury, including motorcycle collision and all-terrain vehicle trauma, unspecified mechanism, and consult activation that are not in the PECARN imaging decision rule. Adding these variables may aid in determining the need for appropriate CT scanning.
    MeSH term(s) Adolescent ; Child ; Humans ; Brain Concussion/diagnostic imaging ; Craniocerebral Trauma/diagnosis ; Decision Support Techniques ; Adverse Childhood Experiences ; Retrospective Studies ; Emergency Service, Hospital ; Brain Injuries, Traumatic/diagnostic imaging
    Language English
    Publishing date 2023-05-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1281159-2
    ISSN 1078-7496
    ISSN 1078-7496
    DOI 10.1097/JTN.0000000000000720
    Database MEDical Literature Analysis and Retrieval System OnLINE

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