FEATURE STORY / UNDERSTANDING CONCUSSIONS
C
oncussions are a growing
public health concern,
accounting for 70-90%
of all traumatic brain
injuries (TBI) worldwide.b Although patients with more severe
TBIs will likely seek medical attention at
a hospital, many patients with mild TBIs
(mTBIs) present at other primary health
care facilities.D With an incidence of six
cases in every 1,000 people, it is likely that
most chiropractors will be involved with an
mTBI case at some point in their career.
The good news is that our
understanding of concussions is constantly
increasing. Chiropractors can be
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establish and run a residency program for
chiropractic students. He worked at the
World Health Organization Collaborating
Center for Neurotrauma in Sweden to
raise over $2 million to fund and operate a
task force to deepen research surrounding
mTBIs. This task force published the first
concussion guidelines in 2004. His work is
a cornerstone for public health education
and can be found on government websites
such as “Concussions Ontario.” Dr.
Cassidy currently divides his time between
Canada and Denmark where he continues
to develop his research and teach at a
number of universities.
Although the breadth and quality of
Athletes who reported three or more
concussions were three times as likely
to be diagnosed with depression.
confident in their knowledge of recovery
expectations, their ability to identify high
risk patients and their ability to effectively
educate patients during the recovery
process. Numerous studies show that early
education and information given to mTBI
patients is beneficial and has positive
outcomes on injury resolution.bDs
This article highlights current
research and patient management by three
chiropractors.
Dr. David Cassidy
D
r. David Cassidy has a long and
rich history of furthering the
chiropractic profession, including
the understanding of concussions. During
his 35-year career, Dr. Cassidy has
published numerous articles and helped to
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FALL 2014
evidence continues to grow, there is still
much that the health care community does
not yet fully understand about mTBIs.
Dr. Cassidy explains that “we should be
concerned about reports that concussions
can cause future brain damage, but
current studies are not rigorous enough
to substantiate this claim. The scientific
evidence is weak.” One reason for the gap
in current research evidence is due to a
focus on short-term effects. Additional
long-term research and examinations of
the links between repetitive concussions
in athletes and late-life neurodegenerative
consequences are warranted.
A positive correlation between
incidence of concussions, late-life
depression and other neurological
disorders has been suggested in football
players and boxers. One study of retired
football players found there was a positive
correlation between the number of
concussions throughout their career and
incidence of late-life depression.u From a
baseline of football players with no history
of concussions, athletes who reported one
or two concussions throughout their career
were 1.5 times as likely to be diagnosed
with depression. Athletes who reported
three or more concussions were three times
as likely to be diagnosed with depression.
While this alerts us to the potential
long-term effects of concussions, more
research is needed. In a study done on
sport concussions with professional football
players, most injured athletes recovered
to pre-injury levels in terms of cognitive
performance within a few weeks. Young
athletes need more recovery time than their
collegiate or professional counterparts and
evidence is being gathered which will aid in
understanding concussion prog