Date of Award

2020

Document Type

Capstone

Degree Name

Doctor of Occupational Therapy

Department

Occupational Therapy

First Advisor

Jyothi Gupta, PhD, OTR/L, FAOTA

Abstract

Objective To review the demographic factors, mechanism of injury, assessments, and treatment by health professionals on a multidisciplinary concussion rehabilitation team in an outpatient clinic setting. Methods: Retrospective chart review of 360 patients attending the outpatient concussion clinic over a 15-month period. Patient data was included for 139 patients meeting inclusion criteria. Data collected on an electronic database was reviewed and analyzed. Results Patients aged 16-82 years (n=139; mean 42 years of age, 65.5% female) were evaluated on average 48 weeks following initial head injury. Patients referred by a physician had a mechanism of injury prevalence of motor vehicle accident (n=80, 57.6%), fall (n=43, 30.9%), and sport related (n=16, 11.5%). Prescribed referrals following a motor vehicle accident, or a fall were most commonly referred to a multidisciplinary team and an individual referral of speech therapy. Sport related concussions had an individual referral of occupational therapy most common followed by a multidisciplinary team. The most common referrals for all patients was a multidisciplinary team (n=43, 30.9%), speech therapy (n=29, 20.9%), and occupational therapy (n=21, 15.1%). Multidisciplinary team individual referrals (ICD-10 codes), assessments, and interventions demonstrated the specialized skill of each healthcare professional at the outpatient clinic. Occupational therapists worked with patients on average for 10.2 visits focused on visual deficits, attention and concentration, and upper extremity coordination. Physical therapists worked with patients on average for 7.7 visits focused on pain, symptoms (headache, dizziness), weakness, and balance. Speech language pathologists worked with patients on average for 12.6 visits focused on cognition, verbal communication, and expression. Conclusion In relation to the high number of concussions or mild TBI's that occur every year, only a very small percentage are seen in an outpatient clinic for rehabilitation. Each healthcare individual on the multidisciplinary concussion team is specialized to administer and interpret different assessments and tools based on their scope of practice and training to provide the best outcomes for concussion patients. This article provides patients and healthcare providers a general overview of one concussion team model that was successful in returning patients to prior level of function in limited visits regardless of how long ago their injury occurred.

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