Downloaded from http://journals.lww.com/headtraumarehab by BhDMf5ePHKbH4TTImqenVICwrFV2GrwdGde9TRaUbTSBjUXuHd/aurl5XEqVWgC+ on 12/08/2019 J Head Trauma Rehabil Vol. 34, No. 6, pp. 425–432 Copyright c  2019 Wolters Kluwer Health, Inc. All rights reserved. Addition of Occupational Therapy to an Interdisciplinary Concussion Clinic Improves Identification of Functional Impairments Madison B. Harris, OTD, MA, OTR/L; Samia Rafeedie, OTD, MA, OTR/L; David McArthur, PhD, MPH; Talin Babikian, PhD; Aliyah Snyder, PhD; Douglas Polster, PhD; Christopher C. Giza, MD Background: Concussions, or mild traumatic brain injuries, are prevalent among youth and young adults. These in- juries may disrupt a person’s daily activities (occupations) including school, physical activity, work, and socialization. Rehabilitation professionals, such as occupational therapists (OTs), are experts in providing individualized inter- vention to address these temporary life changes during recovery. Objective: This article aims to identify the benefit of having an occupational therapy practitioner on an interdisciplinary treatment team when providing intervention to patients with concussion. Setting: Concussion clinic at an academic institution. Participants: Participants ages 12 to 24 years with a reported history of mild traumatic brain injury or concussion were evaluated by a physician, or by a physician and OT, in an initial evaluation appointment. Design: A single researcher (OT) with training in concussion qualitatively compared reported impacted occupational domains as defined in the Occupational Therapy Practice Framework, using both a retrospective and a prospective cohort. The prospective group differed from the retrospective group in that an OT was present, and participated in the initial evaluation. Results: The domains of performance patterns (P = .007) and performance skills (P ≤ .001) were identified significantly more often when an occupational therapy practitioner participated in the initial evaluation. Conclusions: Rehabilitation professionals, such as OTs, play an important role in identifying impacted domains after a concussion, which can help optimize patient care. Key words: concussion, neurology, occupational therapy, pediatrics, quality of life, therapy Author Affiliations: Steve Tisch BrainSPORT Program and Brain Injury Research Center, University of California, Los Angeles (Drs Harris, McArthur, Babikian, Snyder, Polster, and Giza); Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles (Dr Rafeedie). Dr Giza does not believe any of these disclosures represent a direct conflict of interest with the current work; however, in an effort for full transparency, he always elects to disclose all potential conflict of interests. Grants/research sup- port: NCAA, US Department of Defense, UCLA Steve Tisch BrainSPORT program, NIH NINDS (R01 NS27544), UCLA Brain Injury Research Cen- ter, Easton Clinic for Brain Health, NINDS Neural Analytics SBIR grant (NS092209 2016-2018). Consultant: NBA, NFL-Neurological Care Pro- gram, NHLPA. Advisory panel: Highmark Interactive (2018-2019), MLS, NBA, USSF, NCAA Concussion Committee (end 3/2018). Medico-legal: One or two cases annually. Stock shareholder: Highmark Interactive stock options (2018). Other: Book royalties—Blackwell/Wiley Publishing: Priori- tized Neurological Differential Diagnosis. The authors report no conflicts of interest. Corresponding Author: Madison B. Harris, OTD, MA, OTR/L, University of California, Los Angeles, 300 Stein Plaza, UCLA Neurosurgery, #554Q Wasserman Bldg, Los Angeles, CA 90095 (mbharris@mednet.ucla.edu). DOI: 10.1097/HTR.0000000000000544 S PORTS-RELATED CONCUSSION is one of the most common injuries reported in youth and young adults in the United States. Between 1.6 million and 3.8 million concussions occur annually, many resulting from youth sports-related activities. According to the Centers for Disease Control and Prevention, a concus- sion is defined as, “a type of mild traumatic brain injury (mTBI) that is caused by a bump, blow or jolt to the head, or a hit to the body, which causes the head and brain to move rapidly back and forth, creating chemi- cal changes in the neurotransmitters.” 1 These chemical disturbances may cause temporary physical, cognitive, emotional, and sleep-related symptoms that can make it difficult for youth to continue to engage in their daily routines. A majority of people will recover from a con- cussion within 10 days after injury. 2 However, about 20% of people experience a prolonged recovery, lasting longer than 10 days, preventing them from engaging Copyright © 2019 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 425