Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015

Michael W. Collins, Anthony P. Kontos, David O. Okonkwo, Jon Almquist, Julian Bailes, Mark Barisa, Jeffrey Bazarian, O. Josh Bloom, David L. Brody, Robert Cantu, Javier Cardenas, Jay Clugston, Randall Cohen, Ruben Echemendia, R. J. Elbin, Richard Ellenbogen, Janna Fonseca, Gerard Gioia, Kevin Guskiewicz, Robert HeyerGillian Hotz, Grant L. Iverson, Barry Jordan, Geoffrey Manley, Joseph Maroon, Thomas McAllister, Michael McCrea, Anne Mucha, Elizabeth Pieroth, Kenneth Podell, Matthew Pombo, Teena Shetty, Allen Sills, Gary Solomon, Danny G. Thomas, Tamara C. Valovich McLeod, Tony Yates, Ross Zafonte

Research output: Contribution to journalArticle

68 Scopus citations

Abstract

BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion. METHODS: On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device. RESULTS: A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion Treatment: Specific Strategies, and (4) Future Directions: A Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%. CONCLUSION: Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments.

Original languageEnglish (US)
Pages (from-to)912-929
Number of pages18
JournalNeurosurgery
Volume79
Issue number6
DOIs
StatePublished - Dec 1 2016

Keywords

  • Concussion
  • Rehabilitation
  • Treatment
  • mTBI

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Collins, M. W., Kontos, A. P., Okonkwo, D. O., Almquist, J., Bailes, J., Barisa, M., Bazarian, J., Bloom, O. J., Brody, D. L., Cantu, R., Cardenas, J., Clugston, J., Cohen, R., Echemendia, R., Elbin, R. J., Ellenbogen, R., Fonseca, J., Gioia, G., Guskiewicz, K., ... Zafonte, R. (2016). Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015. Neurosurgery, 79(6), 912-929. https://doi.org/10.1227/NEU.0000000000001447