A practical concussion physical examination toolbox

A practical concussion physical examination toolbox

With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination.

In this study, the authors reviewed ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources.

The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment.

Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

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Monica TanakaResearch article posted by: Monica Tanaka

Monica is our Physiospot Editor. She is a trained journalist with a keen interest in the physiotherapy profession. As Physiospot Editor, Monica explores stories and physiotherapy news for us with fresh eyes. She is a science and health communicator with experience implementing strategic communications in the not-for-profit, academic, and public sectors. Thanks to physiotherapists, Monica has kept up her love of cross-country skiing and cycling over the years.

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