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These are—if you'll pardon the expression—heady times for the role of physical therapists (PTs) in care management of people with concussion. Research advances and work being done by PT clinicians across the country have firmly established PTs' place at this table.

Concussion

"There's an ever-stronger evidence base to what we're doing in the treatment arena," says Anne Mucha, PT, DPT, coordinator of vestibular rehabilitation for the Sports Concussion Program and Centers for Rebab Services at the University of Pittsburgh Medical Center (UPMC)—a global leader in testing, treating, and researching sports-related concussions.

"Better and better data lends support to how PTs—as members of multidisciplinary, multifaceted health care teams—consider, manage, and create treatment pathways for concussion in optimal and efficacious ways," says Mucha, a board-certified clinical specialist in neurologic physical therapy. She offers as examples 2 recent findings—1 study showing the benefits of cervicovestibular rehabilitation in decreasing time to medical clearance1 and another indicating slower symptom resolution in a group of adolescents prescribed strict rest, as opposed to "usual care."2

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  1. Schneider KJ, Meeuwisse WH, Nettle-Auirre A, et al. Cervicovestibular rehabilitation in sports-related concussion: a randomised controlled trial. Br J Sports Med. 2014;48:1294-1298.
  2. Thomas DG, Apps JN, Hoffman RG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015;135(2):213-223.
  3. American Physical Therapy Association. The Physical Therapist's Role in Management of the Person With Concussion. (HOD P06-12-12-10) http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/Practice/ManagementConcussion.pdf#search=%22concussion house position%22. Accessed December 12, 2016.
  4. Leddy JJ, Willer B. Use of graded exercise training in concussion and return-to-activity management. Curr Sports Med Rep. 2013;12(6):370-376.
  5. Fremont P, Castonguay E, Pepe-Esposito F, et al, Safe return to play after protocol-based concussion management by a team therapist: a prospective study. Poster presentation, 5th International Conference on Concussion in Sport, Berlin, Germany, October 2016.
  6. McCrory P, Meeuwisse WH, Aubry M, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, Switzerland, November 2012. Br J Sports Med. 2013; 47:250-258.
  7. US Department of Health and Human Services Centers for Disease Control and Prevention. Statistics on Traumatic Brain Injury in the United States. http://cdc.gov/traumaticbraininjury/pdf/BlueBook_factsheet-a.pdf. Accessed December 12, 2016.
  8. Deubert CR, Cohen IG, Lynch HF. Protecting and Promoting the Health of NFL Players: Legal and Ethical Analysis and Recommendations. November 2016. https://footballplayershealth.harvard.edu/wp-content/uploads/2016/11/01_Full_Report.pdf. Accessed December 12, 2016.
  9. UPMC. How knowledgeable are Americans about concussion? Assessing and recalibrating the public's knowledge. http://rethinkconcussions.upmc.com/wp-content/uploads/2015/09/harris-poll-report.pdf. Accessed December 12, 2016.
  10. US Department of Health and Human Services Centers for Disease Control and Prevention. Childhood Obesity Facts. http://www.cdc.gov/healthyschools/obesity/facts.htm. Accessed December 12, 2016.
  11. Collins MW, Kontos AP, Okonkwo DO, et al. Statement on agreements from the targeted evaluation and active management (TEAM) approaches to treating concussion meeting held in Pittsburgh, October 15-16, 2015. http://journals.lww.com/neurosurgery/Citation/2016/12000/Statements_of_Agreement_From_the_Targeted.27.aspx. Accessed December 12, 2016.
  12. Yorke AM, Littleton S, Alsalaheen BA. Concussion attitudes and beliefs, knowledge, and clinical practice: survey of physical therapists. Phys Ther. 2016;96(7):1018-1028.