Concussion Management for Wheelchair Athletes: Evaluation and Examination

Abstract

This book arises from the challenges and difficulties involved in the evaluation and management of concussions in wheelchair athletes. Concussions are most readily identified in the ambulatory population via identifying gross motor instability or when athletes lose their balance and stumble after a blow to the head or neck region. Because wheelchair athletes participate in sport while sitting down and using a wheelchair, clinicians must be extra attentive to identify a potential concussion. Once a potential concussion is identified, there are many challenges in evaluation of the wheelchair athlete population due to their comorbidities. At baseline, they may have signs and symptoms that mimic a concussion, and their impairments can also alter their cognitive and balance assessments. Therefore, it is critical to make a distinction between these athletes’ baseline comorbid impairments and potential new exam findings in a concussion. Filling in a critical gap in the literature, this is a concise pocket guide for any clinician, trainer, or rehabilitation specialist who is involved in wheelchair sports. It focuses on the unique challenges in evaluating a concussion in the wheelchair athlete, including baseline testing, the process of evaluating the signs and symptoms of a concussion, cognitive and vestibular examination, new clinical techniques specific to wheelchair athletes, and the return to play process. A Concussion Management Program (CMP) for use on the sideline as well as in the office is included. Practical and timely, Concussion Management for Wheelchair Athletes is a valuable resource to increase awareness, provide guidance on the unique challenges within this population, and generate interest in future research and investigation.