LOGIC March 2018 Vol 17 Vol 1 - Page 33

For people who have had a mTBI and have ongoing symptoms a referral to Concussion Services is vital. Concussion providers are experts in knowing what to assess and then how to address the needs identified. This can often prevent ongoing issues. There are also specialist providers for children. Concussion Services under ACC contract provide an assessment/triage stage where appropriate assessments are used to identify and prioritise needs. The initial assessment may identify that specialised Allied Health assessment, such as vestibular assessment by a Physiotherapist, is required. Further assessments may be carried out by a Neuropsychologist, Medical Specialist or Optometrist. Sometimes all the client may need is education about their injury, reassurance that it will get better and some simple strategies to manage their symptoms as they return to their usual activities. Others need to continue with a full suite of interdisciplinary input from Occupational Therapy, Speech Language Therapy, Physiotherapy and Neuropsychology, with support from the Medical Specialist March 2018 L.O.G.I.C and/or Optometrist. Occupational Therapy/Speech Therapy can will tend to focus on cognitive-communication skills, fatigue management and return to usual activity. Physiotherapy will focus on vestibular rehabilitation, cervical spine treatment and gradual return to physical function. Neuropsychology will assess cognitive function as well as providing input for mood and impact of the accident on family/whanau relationships, work or study. The team will work with families, schools and employers to ensure the client is fully supported through their recovery. Often referral for Return to Work input under ACC vocational contracts will be necessary to ensure the client achieves a full and sustainable return to employment. important to note, this may be a different sense of fatigue than the one felt after exercising, for example. Brain-injury related fatigue is a mental tiredness, a drained, slowed sensation. This is believed to be due to the extra resources required by the recovery process, forcing the brain to ‘work harder’ on everyday tasks that were relatively effortless prior to the injury. This can have carry-over effects to worsen memory, mood, coordination, headaches, attention, etc. The good news is there are many strategies to support optimal fatigue management. Some such strategies include: • • • Strategies and Resources There are many useful strategies and resources that exist to support recovery from mTBI. These can be discussed and tailored in a rehabilitation programme. Typically without brief education and management of symptoms, frustration at work or at home can build. The most common symptom following a brain injury is fatigue, or an overwhelming sense of physical or mental tiredness. It is • • Learn the early signs of fatigue. Ask your family and friends to help you notice the signs. Take rest periods Schedule important, difficult, or stressful tasks and appointments at times where energy levels are at their peak (for most people, this is in the morning) Spread work, home, and social activities evenly throughout the week and stick to a routine. Plan your activities for the day: o What is most important? 31