Open AccessPractical Management: Brief Physical Examination for Sport-Related Concussion in the Outpatient Setting
Author(s) -
Mohammad Nadir Haider,
John J. Leddy,
William W. Du,
Alexander Macfarlane,
Kaitlin B. Viera,
Barry Willer
Publication year - 2020
Publication title -
clinical journal of sport medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 102
eISSN - 1536-3724
pISSN - 1050-642X
DOI - 10.1097/jsm.0000000000000687
Subject(s) - medicine , concussion , physical examination , physical therapy , physical medicine and rehabilitation , medical emergency , poison control , injury prevention , surgery
This article presents a brief, focused physical examination [PE, the Buffalo Concussion Physical Examination (BCPE)] for sport-related concussion (SRC) to be considered for use in the outpatient setting by sports medicine physicians, pediatricians, and primary-care physicians. This companion paper describes how to perform the PE, which was derived in a separate study presented in this journal. It is envisioned for use at the initial and follow-up outpatient visits both for acute concussions and in patients with prolonged symptoms. A pertinent PE, combined with other assessments, can help identify specific treatment targets in those with persistent symptoms after SRC. The BCPE includes orthostatic vital signs and examinations of the cranial nerves, oculomotor/ophthalmologic, cervical, and vestibular systems. Supplementary tests, including testing for exercise tolerance and neurocognitive function, may be performed if indicated. It is recommended that a PE be performed at the initial visit and every 1 to 2 weeks after SRC. On return of symptoms, cognition, and the PE to baseline, as well as normalization of any supplementary tests, patients can begin a return to play program.