Center for Injury Research and Prevention

Concussion Treatments and Recovery

Concussion Treatments and Recovery

CHOP’s Minds Matter program has demonstrated a fundamentally forward-thinking mind-set with our comprehensive approach to phenotyping concussion with clinical and objective measures and the adoption of an active therapeutic approach to treatment; in contrast, international experts and other practitioners in the region still recommend rest with minimal guidance about active therapies.

We reject the notion that all concussions are the same and should be treated with the same, passive approach. Our research continues to use novel methods to quantify recovery and enroll concussed patients in randomized clinical trials to further investigate promising active therapies.

By implementing a personalized approach to concussion care, we can target specific deficits through emerging novel treatments to accelerate recovery and improve quality of life for these children.

Concussion Treatments Research

  • AMSSM Exercise Therapy Trial -- This multicenter, randomized controlled trial investigates if sub-symptom threshold aerobic exercise in adolescents with a recent sport-related concussion improves time to recovery compared to non-aerobic stretching activities. The study enrolls adolescents within 10 days of sport-related concussion, who complete a randomly assigned daily activity (exercise vs. stretching), report daily symptoms in a mobile app, and return for weekly follow-up visits for up to 4 weeks post-injury, unless they recover sooner. The study is a collaborative effort between CHOP, University at Buffalo, and Boston Children’s Hospital. Principal Investigator: Christina L Master, MD, CAQSM; Funding: American Medical Society for Sports Medicine (AMSSM)
  • HIT HEADS Trial of Dietary Supplements -- HIT HEADS stands for “Head Injury Treatment with Healthy and Advanced Dietary Supplements.” Clinician-researchers have worked to increase therapeutic options for treating concussions. One line of inquiry concerns the potential role for dietary supplements. The HIT HEADS study is a randomized, placebo-controlled, double-blinded, therapeutic exploratory clinical trial of dietary supplements in the treatment of sports-related concussion. Principal Investigators: Akiva Cohen, PhD, Sage Myers, MDFunding: Dana Foundation
  • Vestibular Rehabilitation -- This study sought to determine whether active vestibular rehabilitation was associated with improvement in visio-vestibular deficits in children with concussion. In a sample of over 100 children with concussion who were referred to vestibular rehabilitation, symptoms decreased and performance on visio-vestibular tasks and the Balance Error Scoring System improved, after the course of therapy. Future work should determine the optimal post-injury timing of this rehabilitation. Principal Investigator: Christina L Master, MD, CAQSM; Funding: Children's Hospital of Philadelphia
  • Practice Patterns in Pharmacological and non-Pharmacological Therapies -- In a survey of multiple clinical sites in North America, we explored common practice variation in the management of pediatric concussion, with a focus on understanding the frequency at which providers prescribed medications (e.g. non-steroidal anti-inflammatories) and other therapies (e.g. rest or exercise therapy). Journal of Neurotrauma. 2019. Principal Investigator: Christina L Master, MD, CAQSM; Funding: Children's Hospital of Philadelphia

Concussion Recovery Research

  • Concussion Recovery App: Use of Ecologic Momentary Assessment (EMA) to Track Symptoms -- As a research strategy, EMA can capture objective measures of physical activity, reports of cognitive activity, and symptomatology in real time in pediatric patients. With EMA, we can understand the time-varying nature of concussion recovery in youth. As a clinical tool, EMA can help clinicians monitor their patients’ recovery in real-time and adjust care plans accordingly. The Research Team: (CHOP) Christina L Master, MD, CAQSMMichael L. Nance, MDEileen Houseknecht, RN, and Matthew Grady, MD; (Penn) Douglas Wiebe, PhD (a CIRP Senior Fellow), Nicole Otto, MD, and Danielle Sandsmark, MD; Funding: Penn Medicine Translational Neuroscience Center
  • Driving after Concussion: Examination of the Adolescent Brain and Behaviors -- This 4-year research project aims to establish the evidence base for return to drive recommendations for adolescents after a concussion. The objective is to examine the neurophysiological functioning of the recovering concussed adolescent brain while managing driving tasks, the association between their neurophysiological functioning and clinical assessments, and the nature of concussed adolescents’ engagement in risky driving behaviors. The project will employ driving simulation, fNIRS, and pupillometry as measures of neurophysiological function; examine the association of these objective measures with clinical assessments; and prospectively quantify driving behaviors of concussed adolescents with objective on-road in-vehicle monitoring and ecological momentary monitoring of concussion symptoms. Principal Investigator: Catherine McDonald, PhD, RNCo-Investigators: Kristy Arbogast, PhD, Christina L Master, MD, CAQSM, Allison Curry, PhD, Douglas Wiebe, PhD, Kit Delgado, MD, Hasan Ayaz, PhDFunding: National Institute of Nursing Research