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A Case Study of Concussion Treatment for children at City Osteopaths and City Hyperbaric Wellington.

6/16/2016

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Climbing trees is a fantastic part of life for kids in New Zealand. It teaches them balance, coordination and bravery. However sometimes they can and do fall.

​What do you do if your child falls out of a tree and suffers from a concussion or Mild Traumatic Brain Injury?

You need to go straight to accident and emergency for assessment or to your GP if the initial symptoms are less severe. 

Recently at City Hyperbaric we saw a ten year old boy who loves climbing trees. He swung in a tree and hit his head, causing a loss of consciousness of around ten minutes and resulting in a fortnight off school.

​Four weeks later he was still suffering from the concussion so came up from the South Island to our practice. On doing our head injury questionnaire, it showed his behaviour was very difficult and he was suffering constant headaches of 8 or 9/10 severity. He had reduced attention span, impaired comprehension, dizziness and angry outbursts all 7-9/10 in severity.

This is what we did to help him recover:
  • He had two gentle osteopathic treatments, five days apart.
  • He had two 60 minute Hyperbaric Oxygen Therapy  sessions each day for the seven days (14 in total).
  • By the Wednesday (third day of treatment) his headaches were down to a 6/10 and his mother reported his behaviour was improving
  • By Saturday his headaches were 2 or 3/10.
  • On the final/seventh day he re-did our head injury questionnaire and had improved on all parameters. His headaches were now 0/10 and his attention span, anxiety, dizziness and angry behaviour were all 0/10 or 2/10
  • What was really wonderful was that he had returned to his calm, happy, curious self.
  • I have followed up with his mother now six weeks on and he has not had any headaches at all since the combined Osteopathic and Hyperbaric Oxygen Therapy Treatment. ​
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The Featherston St City Hyperbaric Chamber
All our Hyperbaric technicians are trained, experienced and skilled. Before coming in for a session you will be sent a HBOT medical questionnaire and when you arrive the process will be fully explained. The most important ability you need for going in the chamber is to be able to equalise your ears as if you were flying or diving. At City Osteopaths and City Hyperbaric we like to work in with your concussion care team to help you make the optimal recovery.

Some research on HBOT and for Head injury:
“Role of Hyperbaric Oxygen Therapy in Severe Head Injury in Children” 
—Journal of Pediatric Neuroscience. 2012 Jan-April 7(1) 4-8 
Conclusion: In children with traumatic brain injury, the addition of HBOT significantly improved outcome and quality of life and reduced risk of complications. Patients receiving HBOT were significantly better than the control group with decreased hospital stay, better Glasgow Coma Scale and drastic reduction in disability. 

“Hyperbaric Oxygen Therapy can improve Post Concussion Syndrome years after Mild Traumatic Brain Injury – Randomised Prospective Trial” 
—PLoS One November 2013 10.137/journal.pone 0079995
Conclusion: Convincing results based on a crossover study, demonstrating that HBOT can induce neuroplasticity and significant brain function improvement in mild TBI patients with prolonged Post-Concussion-Syndrome at late chronic stage, years after injury.
​
Please see our information page here http://www.cityosteopaths.co.nz/hyperbaric.html for more detailed information including the costs and more research. We do provide a discounted Hyperbaric Oxygen Therapy fee for children with a head injury on a case by case basis.
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Melanie Young
B.A., B.App.Sc.,(Clin.Sc.),B.Osteo.Sc.
Reg Osteopath
Director City Osteopaths
Wellington
​www.cityhyperbaric.co.nz
​www.cityosteopaths.co.nz

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What to do for a concussion or mild head injury/traumatic brain injury? Concussion Care Clinic at City Osteopaths, Wellington.

6/1/2016

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PictureThere are approximately 8000 concussions in New Zealand every year.
A concussion is a brain injury. It may involve loss of consciousness. However, a concussion most often occurs without a loss of consciousness.

Concussions happen when bumps, blows or jolts to the head or body cause the brain to move around inside the skull. It may also result from a whiplash effect to the head and neck. The brain injury that results can be mild or more severe and can disrupt how the brain normally works by causing bruising and swelling inside the skull which presses on sensitive neural tissue (brain).

Concussions can be hard to recognise because there may not be obvious signs of trauma. Signs and symptoms may have delayed onset and may be worse later that day or even the next morning.


Initial Response: If there is a loss of consciousness, call an ambulance by phoning 111. Assume possible neck injury. Only remove the victim from the current situation if it is dangerous to remain there. Do not leave the injured person alone: monitor signs and symptoms.  The injured person should be evaluated by a trained health professional and they should not return to the activity until all steps below are clear.

Signs and Symptoms
  • Poor balance or coordination
  • Slow or slurred speech
  • Poor concentration
  • Delayed responses to questions
  • Vacant Stare
  • Unusual emotions
  • Personality change
  • Inappropriate behaviour
  • Headache
  • Dizziness
  • Feeling Dazed
  • Seeing stars
  • Sensitivity to light
  • Ringing in ears
  • Tiredness
  • Nausea
  • Vomiting
  • Irritability
  • Confusion
  • Disorientation

Steps for Returning to Normal Activity
The only treatment for a concussion is complete rest until all signs and symptoms resolve. Complete rest includes rest for the body (no playing sports or doing chores)  and for the brain (no TV, video games or extensive reading). Each step should be last a minimum of one day.

Signs and symptoms may return later that day or the next and not necessarily when exercising. If signs and symptoms return you should return to the previous step and be re-evaluated by a health care professional.

Step 1: No Activity - complete physical and cognitive rest. Proceed to next step only when symptoms are gone

Step 2: Light Activity - walking, swimming, cycling. light chores, reading, partial return to work/school

Step 3: Some Skilled Activity - Simple non-contact drills in sport, more time spent at school or work

Step 4: More Skilled Activity - progress to more complex drills in sport, may start progressive resistance training, not-contact play with other people

Step 5: Normal Routine and School/Work Routine - Following medical clearance you may participate in normal sport practices, games, chores,  and your normal work and school routines

Note: The injured person should proceed through the above steps only when they do not experience symptoms or signs and a physician has given the clearance. If symptoms or signs return the injured person should return to the previous step and be re-evaluated by a trained health professional.

At City Osteopaths we have a Concussion Care Clinic. We have found that gentle osteopathic treatment combined with mild Hyperbaric Oxygen Therapy (mHBOT) is very helpful in aiding recovery from the symptoms of concussion listed above. 

How do we do this? Gentle treatment of the muscles, fascia and nerves of the neck and upper back along with assisting normal tension of the membranes in the head, can allow an improvement in blood supply to the brain and drainage from the brain. To help concussion symptoms ease even further we combine this with Hyperbaric Oxygen Therapy to improve oxygen to dormant parts of the brain and reduce swelling to really help the brain function again.


If you have had a concussion please call our practice on 4991439 and make an appointment to come and see one of our gentle osteopaths for an assessment so we can work out the best protocol of treatment for you to help you get back to feeling like your self again.

Melanie Young
B.A., BSc.(Clin Sc.) B.Osteo Sc. MONZ
Reg Osteopath
​Director City Osteopaths


www.cityosteopaths.co.nz
http://www.cityosteopaths.co.nz/osteopathy.html#l1 for our Osteopathic Team
http://www.cityosteopaths.co.nz/hyperbaric.html for more information on HBOT


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