Concussion


Each year, 1.6 to 3.8 million concussions occur in recreational and sports-related activities.


Signs and Symptoms

Concussion patients often suffer from issues that are noted as invisible injuries. These symptoms do not show on imaging, yet they are often disabling. Symptoms commonly associated with a concussion include visual changes, dizziness, behavioural changes, fatigue, aggression, impulsivity, irritability, anxiety, depression, fatigue, disrupted sleep patterns, nausea, vomiting, persistent headache, and ringing in the ears. Note that someone does not have to lose consciousness in order to have suffered a concussion.

What Is A Concussion?

The most common type of traumatic brain injury (TBI) is called a concussion. Concussions, which are a form of mild TBI, are not visible on traditional imaging such as MRI or CT scan. Symptoms are seen as a result of subtle changes that occur at the cellular level. Concussions come with long-term risk especially when a person has had several concussive events. Multi concussive events can cause chronic neuroinflammation and can lead to chronic traumatic encephalopathy (CTE). CTE is a neurodegenerative disease caused by multiple traumatic insults on the brain.

A concussion occurs when the brain slams against the inside of the skull. A concussion causes injury in two places, since the brain strikes the inside of the skull first at the point of impact and then again on the opposite side as it “rebounds” away from the impact site. If the head rotates at the time of impact there can also be damage to the axons that connect the brain’s grey matter to the white matter below.

Our Approach to Concussion

Revive utilizes research-based diagnostics to evaluate function in specific areas of the brain. Looking at eye movements, motor function, sensory function, cranial nerves, cognitive function, balance, and gait allows us to better understand which areas have been affected by the concussion. This allows us to develop a treatment plan that targets those regions and networks to make them stronger and more efficient.

We specialize in providing treatment to the neurological regions affected by the concussion. Offering a unique process that is built to maximize results in a condensed period of time. To reach your personal healthcare goals, it is imperative that your physicians and care providers know your individual story and desires. Your individual goals are the focal point of the comprehensive treatment plan which is based off your exam, diagnostics, and lab results.

Beyond the neurological system, there are many factors that can impact the presentation of concussion: the immune system, diet, sleep, mindset and stress (to list a few). By integrating knowledge of the brain and influence of these factors, we are able to be very specific with targeted therapies which create lasting neurological changes. Your treatment plan is designed specifically for you and your brain’s needs.

This plan is executed over 10 days. Patients see measurable improvement during their time in our office and continue to make gains once they leave. To help ensure success on your journey of healing, we create and define a plan for you when you go home. This plan may include sourcing a local specialist for a safe and effective continuum of care. Our goal is to see each patient continue to build upon the initial results they achieved in our office.

Revive's Treatment Options for Post-Concussion Syndrome (PCS)


Level 1 Post-Concussion Syndrome (PCS) Treatment Package: Revive’s Standard Treatment Suite

 

Diagnostics

Videonystagmography (VNG) testing for eyes

Vestibular testing

Full history exam

Metabolic assessment

Neurological exam

Psychiatric exam

 

Neurological Rehabilitation Treatments

Repetitive Transcranial Magnetic Stimulation (rTMS)

Eye Therapy

Electrical Stimulation (ReBuilder, SSEP)

Functional Movement Therapy

Vestibular Therapy (GyroStim)

Cold Laser Therapy (Low Level Laser Therapy – LLLT)

Sensory Motor Integration (SMI)

Meditation / Breathing Coaching

Hyperbaric Oxygen Therapy (HBOT)

 

Post-Care

– Specialized Supplement Package

– At-Home Exercise Videos

– Dietary Recommendations

– Follow-Up Phone Calls, Video Call, Coaching


Level 2 Post-Concussion Syndrome (PCS) Treatment Package: Standard Suite + Infusions

 


Level 3 Post-Concussion Syndrome (PCS) Treatment Package: Standard Suite + Infusions + Regenerative Cell Therapy

 


Research on our Treatments

Repetitive Transcranial Magnetic Stimulation (rTMS) sends a magnetic waveform through the skull that depolarizes the brain cells. rTMS can be directed at specific regions of the cortex to cause activation of the neurons in the area.

Hyperbaric oxygen therapy (HBOT) is the medical use of oxygen in a pressurized environment, at a level higher than 1 atmosphere absolute (ATA). Increased pressure allows for oxygen to dissolve and saturate the blood plasma (independent of hemoglobin/red blood cells), which yields a broad variety of positive physiological, biochemical and cellular effects. This noninvasive therapy is the most trusted way to increase oxygen levels to all organs of the body. The typical treatment lasts for 60-90 minutes, during which the patient lies down and breathes normally. HBOT has been demonstrated in several clinical studies to enhance the body’s innate ability to repair and regenerate. It is used as an adjunct therapy to complement and enhance the healing process in both chronic and acute conditions.

Hyperbaric Oxygen Therapy (HBOT) has been shown to increase oxygen saturation to tissues and increase the amount of stem cell production and circulation. This allows for the greatest potential for healing in the brain.

We utilize Electrical Stimulation (E-stim) in many different waveforms to increase strength, increase self-awareness, decrease spasticity, and active brainstem neurons.  

AL-TENS/SSEP
AL-TENS is a form of hyperstimulation described by Sjölund and colleagues in the 1970s. The intention of AL-TENS is to stimulate small diameter, high threshold peripheral afferents (A-delta) in order to activate extrasegmental descending pain inhibitory pathways. Non-painful muscle twitches occur during stimulation causing activity in small diameter muscle afferents. Electrodes are positioned over myotomes, trigger points, and acupuncture points. The term AL-TENS is used loosely in literature making the synthesis of research findings difficult.

ReBuilder
In effect, the ReBuilder acts like a pacemaker works for your heart’s electrical signals. If the pacemaker does not send exactly the right signal, then the four chambers of the heart may not pump in the right order and if the signal is too fast or too slow, the heart stops. So, too, the ReBuilder’s precisely controlled waveform coaxes your nerves to transmit their signals in the proper order. Although designated as a TENS relative to the FDA’s regulations, the ReBuilder’s signals are vastly more controlled and precise.

The ReBuilder is typically used on patients as a neurological intervention to help with cortical remapping. If the brain is unsure of where the feet are in space after a stroke or other biomechanical event, the ReBuilder can help strengthen those signaling pathways. Additionally, vagal stimulation or gait protocols may be used for similar reasons.

Sensory Motor Integration (SMI) can help increase reaction time and motor skills. SMI is strongly researched in the world of developmental delays and can be adapted to affect many different disorders.
Cold Laser Therapy, also known as Low Level Laser Therapy (LLLT), has shown increases in mitochondria production in cells, helping to decrease inflammation and increase healthy cellular activity. When the cold laser is utilized as a transcranial (through the skull) therapy we see an increase in brain activation to the targeted areas.

Vestibular/Rotational Therapy is a very powerful tool in the world of neurological rehabilitation. When we look at brain development we see that movement drive brain growth and one of the most important areas for sensing movement is the vestibular system. When we utilize rotational therapy to active the vestibular system we see an increase in activating in several cortical regions. Our multi-axis rotational device (GyroStim) utilizes the otolithic and vestibular system to stimulate and strengthen projections throughout the brain. By utilizing a controlled directional spin in our multi-axis rotational device, we can activate specific regions of the brain in order to affect a variety of different disorders.

At lower levels of motion intensity, the multi-axis rotational device is used by those recovering from physical and cognitive dysfunction as a result of a concussion, traumatic brain injury, PTSD, autism, aging, and other conditions. At higher levels of intensity, GyroStim is used by active individuals, athletes, and others with fast-paced, demanding, high-stress lifestyles to maintain and enhance peak performance.