Mild TBI Task Force
To enhance the quality and uptake of concussion research, and to improve clinical care for concussion. If you are interested in joining this task force, please contact the chair, Noah Silverberg.
Noah Silverberg, PhD RPsych ABPP
Clinical Associate Professor, University of British Columbia
Acquired Brain Injury Program, G.F. Strong Rehab Centre
Vancouver, BC Canada
- Re-formed the task force in October 2017
- Assembled core interdisciplinary group of returning and new members
- First monthly teleconference was held 16 November 2017
The proposed 2017-2018 agenda for the task force is as follows:
Project 1: Information/Education Page
Several new clinical practice guidelines for managing concussions have been released within the last five years, from sport, military, and civilian organizations. Recommendations for return to activity after concussion have changed considerably, from an emphasis on rest to early activity resumption as tolerated. Most patient education materials (webpages, apps, pamphlets, etc.) contain outdated return to activity recommendations. The Task Force hopes to create an updated patient guide for returning to activity after concussion/mild traumatic brain injury, adapting stepwise return to learn/play guidelines for a more general lay audience, including adults returning to work. Product: “Returning to activity after a concussion” as an Archives of Physical Medicine and Rehabilitation Information/Education Page.
Project 2: Concussion Primer for Primary Care Providers
Concussion care has evolved rapidly, making it difficult for family physicians to stay abreast with current evidence-based practice. Most knowledge translation efforts have focused on sports medicine and emergency medicine physicians. The majority of adults with concussion do not sustain their injury in sports and many do not seek care in an emergency department. Moreover, family physicians are well-positioned to implement early symptom management strategies through the post-acute period.
The task force will write a primer on concussion specifically for a family physician audience. The paper will outline a diagnostic algorithm for diagnosing concussions in a primary care setting and synthesize contemporary clinical practice guidelines most relevant to family physicians. Product: “Diagnosis and management of concussion/mild traumatic brain injury for primary care providers” to be published in a family medicine journal.
Project 3: Peer-Reviewed Journal Article
Concussion research has been hampered by inadequate outcome measures and inconsistent use of available measures. There is little consensus on what constitutes a “good” vs. “bad” outcome from this injury, making it challenging to compare or synthesize studies. The Task Force hopes to undertake a scoping review of outcome measures used in concussion/mild traumatic brain injury observational studies and clinical trials. The aim of the review is to survey the breadth of outcome measures used, how they are analyzed (e.g., dichotomized using different cut-points), what is known about their psychometric properties (e.g., minimal clinically important difference), and how they map on to health domains. Product: “Scoping review of outcome measures for concussion/mild traumatic brain injury research,” a peer reviewed journal article.