Summary

In this episode, Melvin Pitz and Cornel Tol from the Headache, Pain, and Concussion Training Institute (HPCTI) delve into the intricacies of managing concussions and post-concussion symptoms. They advocate for using the term "prolonged post-concussion symptoms" over "mild traumatic brain injury" to reduce the nocebo effect associated with the latter.

The discussion highlights the importance of a multidisciplinary and biopsychosocial approach in diagnosis and treatment, emphasizing the significance of early intervention and patient education. Melvin and Cornel share insights into diagnostic criteria, the impact of framing on patient outcomes, and the gaps in current practices, particularly in the Netherlands. They stress the need for physiotherapists to be proactive in education and networking to bridge the knowledge gap in concussion management.

The episode also touches on the neurophysiological aspects of concussion, the shortcomings of monodisciplinary approaches, and the potential of a treatable traits approach for better patient outcomes. Listeners are encouraged to rethink the role of physiotherapy and consider the broader implications of prolonged symptoms, including psychological and social factors. The episode provides practical advice for physiotherapists and healthcare professionals on how to improve their practice and patient care in the context of concussions.

Guests

Today’s guests are Melvin Pitz and Cornel Tol from the HPC-TI — short for Headache, Pain & Concussion Training Institute. They’re on a mission to educate and empower healthcare professionals with cutting-edge, evidence-based strategies to manage headache, pain complaints, and mild traumatic brain injury. With a strong clinical background and a critical view on how care is currently delivered, they’re pushing for a multidisciplinary and biopsychosocial approach that actually works — in the clinic, and beyond

Content

00:00 Intro

00:41 Definition of PPCS

03:06 Diagnostic Criteria

06:35 Gaps in recognizing PPCS

09:47 Why patients are misdiagnosed

14:24 Sponsor

15:00 Prognostic Factors to develop prolonged symptoms

18:48 Rethinking Physiotherapists' role in treating PPCS

24:40 Neurophysiology of PPCS

28:28 Why monodisciplinary approaches fail

33:12 Diagnosis & Decisionmaking

35:48 Sponsor

37:04 Biggest pitfalls

38:44 Treatment

50:48 Interesting Case Studies

57:38 Return to work/play

01:03:21 Opinion on high-impact sports

01:05:25 Myths to bust

01:06:26 Closing thoughts

01:07:37 Contact info & Outro

Bonus Material

Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App.

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