Management of mTBI in Children: From Bench to Bedside (Part 2)



Barry Willer


Barry Willer
John Leddy
Christina Master



The symposium will be presented in two parts. Part 2 will focus on the management and treatment of mTBI sub-divided into (a) Autonomic nervous system dysfunction from mTBI (b) Assessment and treatment of vestibular and oculomotor difficulties, (c) Exercise as medicine and (d) Panel discussion.

Part 2:

(a) Autonomic Nervous System dysfunction following mTBI: 
Dr. Leddy will describe the effects of mTBI on the sympathetic and parasympathetic nervous system of children and adolescents. He will describe the experimental evidence that demonstrates the difficulty children have achieving a sympathetic state after concussion and similarly, the difficulty achieving a parasympathetic state. The end result is loss of autonomic control of important functions like achieving a sleep state or controlling cerebral blood flow.

(b) Assessment and treatment of vestibular and oculomotor difficulties: Presenter is Christina Master.
Children that do not recover from mTBI in the usual time period are often suffering from vestibular and oculomotor difficulties. The assessment of these difficulties in the acute phase of injury helps to identify children at risk of delayed recovery early in the process and improve the chances of good outcomes. Dr. Master will describe the latest in assessment and treatment protocols for vestibular and oculomotor dysfunction.

(c) Exercise as Medicine: 
Dr. Willer will describe the results of a randomized controlled trial (RCT) of aerobic exercise versus stretching exercise study. The study is completed and currently being replicated in a multi site trial involving the participants in this symposium. The results of the RCT clearly indicate that exercise is medicine, that is, assists in recovery. The time to recovery is better and the number of adolescents who have delayed recovery is reduced. Females appear to benefit more from prescribed exercise than males.

(d) All of the presenters from both symposia (parts 1 and 2) will participate in a panel discussion at the end of the second symposium to discuss any issues raised by the audience during the presentations or upon reflection.



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