A Good Way to Find Winter Boots with Good Treads

My neurosurgeon, Dr. Charles Tator is quite well renowned in the world of concussion. During my first appointment with him he indicated “You’ve probably figured out by now that the medical community doesn’t know much about concussion. If you ask 10 different doctors what a concussion is, you will get 10 different answers. But the one thing we do know is that concussion is cumulative.”

We all need to be careful, but people who have already sustained an Acquired Brain Injury (ABI) need to be especially careful to ensure they don’t sustain another blow to the head. I have met a few ABI survivors who have received another hit to the head and all of them said it brought all the symptoms back to the level they were at after their initial ABI.

With all the freeze/thaw and freezing rain we have had in Ontario this winter, we all need to be especially careful and proper footwear is a must. Here’s a website that shows the results of thorough testing on various boots’ treads in terms of how well they perform in various winter conditions.

http://www.ratemytreads.com/

My winter boots are still in good shape, but I have had a couple of close calls on ice this winter so I stopped by Mark’s this morning to try on the Wind River boots that ranked the highest in the women’s category (the “Cascade” model). I was impressed to see they have little shards of something that seem like glass embedded right in the rubber tread.

They are currently on sale so I ordered them online in my size.

Better safe than sorry!

The Value of Exercise During the Acute Concussion Phase

Katy Kumar, who runs the Ontario Brain Injury Association’s (OBIA’s) help line recently discovered a very important article and has shared it with her network in the industry. From past brain injury conferences I have attended, I too had started hearing that the latest research was indicating that the old advice of complete physical and mental rest in a dark silent room after a concussion was proving to not be the best advice beyond a couple of days.

According to this article, “the study by University at Buffalo researchers and colleagues, is the first randomized clinical trial of a treatment in the acute phase after a sport-related concussion.” The goal of the study was to evaluate allowing adolescents who had sustained a concussion to resume a level of activity that didn’t trigger their symptoms (after a few days of rest).

The study included 103 kids aged 13-18, with nearly equal numbers of boys and girls. All were seen within 10 days after sustaining a sport-related concussion. The study found “patients who followed the aerobic exercise program took on average 13 days to recover while those in the control group, who performed stretching exercises, took 17 days. In addition, fewer patients in the exercise program took longer than four weeks to recover than did patients in the control group.”

““This research provides the strongest evidence yet that a prescribed, individualized aerobic exercise program that keeps the heart rate below the point where symptoms worsen is the best way to treat concussion in adolescents,” said John J. Leddy, MD, Director of the UB Concussion Management Clinic at UBMD Orthopaedics and Sports Medicine.”

To determine how much exercise each patient could tolerate without triggering their concussion symptoms, researchers had the patient walk on a treadmill while they gradually increased the incline until the patient’s symptoms worsened. They recorded the patient’s heart rate at the point the symptoms worsened. Researchers then prescribed exercise at 80% of that heart rate. Patients wore a heart rate monitor so they could make sure they stayed below the threshold while exercising. Patients performed their assigned exercise for about 20 minutes each day in the beginning, but the amount of exercise was gradually increased over time (as symptoms improved).

Another key finding in the study was “the lower the threshold of activity at which symptoms increase, is a key clinical indicator of how severe the concussion may be”.

The researchers plan to investigate if the treatment is also effective in adults with concussion. I’m very much looking forward to seeing those results as well. I personally believe that regularly attending organized exercise classes has had a big impact on my recovery. Feel free to use the comments section below to share your thoughts on/experience with exercise & concussion recovery.

To read the full article click the link below.

http://www.buffalo.edu/news/releases/2019/02/002.html

Education & Support Workshop – “When Symptoms of Single and Multiple Concussions Persist”

A friend of mine was at Toronto Western Hospital today and sent me a copy of this flyer advertising a two-night workshop on lingering symptoms from concussion. The last session of 2018 is being held this week on the nights of  Nov 6 & 8  (i.e. two nights total) from 7-9pm at Toronto Western Hospital.

Thankfully they are considerate of the people who would like access to the information but can’t make it to their session in person so they recorded past sessions and put the videos online. You can access the videos using this link:

https://www.uhn.ca/KNC/Research/Projects/Canadian_Concussion_Centre/Pages/patient.aspx

 

Another Sad Story of Football-Related Head Injury

Unfortunately there are all too many stories of concussion in sport. This particular one highlights the long lasting cognitive, mood and personality changes that can occur when concussion symptoms persist or when Chronic Traumatic Encephalopathy (CTE – which can result from many concussions) develops. Unfortunately the football associations themselves often seem more concerned with running defense than with helping the injured player. Sadly, in this situation they did not follow the concussion protocols that have been developed for sports.

In Canada, Parachute Canada has developed these sports protocols . This story highlights the incredible long-lasting impacts concussion can have on the injured player and on that player’s family and the friends that choose to stick by him/her afterwards. If you are a coach, team doctor or therapist or even a parent with a child in a sport we all need to play a role in ensuring these protocols are followed and if the person does receive a brain injury, please do your part in spite of the personality changes to help the person down the long road to recovery.

 

 

Brain Plasticity by Brain Researcher Dr. Lara Boyd

I discovered a good TEDx talk from a brain researcher in Vancouver, Dr. Lara Boyd. In it she describes the chemical and structural changes that occur in your brain during neuroplasticity (brain changes). The key points I took away were:

  • Her work with people recovering from stroke shows a lot of variability in results from person to person.
  • The primary driver of brain change is your behaviour. “There is no neuroplasticity drug you can take. Nothing is more effective than practice at helping you learn. The bottom line is you have to do the work.”
  • Increased difficulty/increased struggle in what you are practicing results in not only more learning but also greater structural change in the brain.
  • Neuroplasticity can be either positive (e.g. learn something new) or negative (e.g. become addicted to drugs, have chronic pain).
  • Neuroplasticity is shaped by everything you do and everything you don’t do.
  • There is no one size fits all approach to learning. There is no one intervention that will work for all of us. This has forced the researchers to look further into “personalized medicine” (unique interventions).
  • Biomarkers in the brain are helping them to match therapies with individual patients recovering from stroke.
  • Not only do we need personalized medicine, we need personalized learning.
  • Even for people without a brain injury/stroke, behaviours in your everyday life and things you encounter are important because each of them is changing your brain for better or for worse.
  • Break bad habits. Do the positive learning that your brain requires. Build the brain you want.

Concussion Information Booklet for Patients and Families

The Ontario Neurotrauma Foundation (ONF) has recently released a new Concussion Information Booklet for Patients and Families. It is excellent and I hope multiple copies are delivered to every hospital emergency room and general physician’s office for distribution to people with a concussion. Here is a link to download a copy of it:

http://concussionsontario.org/wp-content/uploads/2018/04/ONF-Concussion-Booklet-Web-Feedback-link.pdf

Representatives of the ONF were at the recent Concussion Public Forum in Toronto to distribute copies of it. They indicated they would like to receive feedback on it from patients and families at info@onf.org or through Twitter @ontneurotrauma.

The representatives indicated the purpose of this guide is to help you navigate through the industry after potentially receiving a concussion. The ONF has developed concussion standards by working with 100 stakeholders including people with lived experience and their family members. They found that concussion was becoming a business and people were calling themselves “concussion experts” without proper training. The ONF’s concussion standards and this guide are intended to help deal with this issue.

 

Concussion Public Forum in Toronto, ON

There will be a free public information night with the dual themes of “The Consequences of Concussions” and “Concussions Through the Eyes of Concussion Sufferers and Their Families” to be held on the evening of Friday May 11th at Toronto Western Hospital in Toronto.

Here is a link to the agenda:

https://ers.snapuptickets.com/ers/event-files/2495/Public_Forum_Program_Apr_4.pdf

Here is a link to the registration form:

https://ers.snapuptickets.com/ers/online-registration-conference-form.cfm?event=2495&lan=eng&RegType=2

If you decide to register, once you enter your information on this form and click “Continue” then review your information and if it is correct, make sure you click the “Complete Registration” button which is in grey at the bottom of the screen (it’s not that obvious).

New Study Indicates Number & Severity of Brain Injuries Raises Dementia Risk

A large study offers more evidence of a link between traumatic brain injuries and dementia later in life, with repeated injuries and severe ones posing the greatest danger.

According to the study’s results, a single severe brain injury increased the risk of later developing dementia by 35 per cent compared with a person who never had brain trauma. A mild brain injury increased the risk by 17 per cent.

But, also note the line “Overall, the risk was small. About 95 per cent of people who suffered a brain injury never developed dementia.”

To read the full article in The Star, click the link below, or if you would prefer to have the article read aloud to you, simply click the play button below.

https://www.thestar.com/life/2018/04/11/new-study-says-number-severity-of-brain-injuries-raises-dementia-risk.html

Dr. Charles Tator’s 2017 Presentation on Photosensitivity in Women with Post Concussion Syndrome

Here is a link to video presentation which Dr. Charles Tator, a neurosurgeon at Toronto Western Hospital, gave at a 2017 “Concussion in Women and Girls Conference” in Toronto. His presentation is currently available online. In this presentation, Dr. Tator provides some information about women with Post Concussion Syndrome (PCS) who experience photosensitivity (a.k.a. photophobia). He also describes a study that he was involved with where they had 29 people with PCS use a “non LCD” device instead of a traditional computer monitor. The device had a slower refresh rate (so less flicker) than a typical computer monitor and did not have a backlit screen.

http://www.uhn.ca/KNC/Research/Projects/Canadian_Concussion_Centre/Pages/symposia.aspx