Question:
Jamie Pardini, PhD: “I’m going to layer these cause they’re kind of similar. Can you use it to track progress. If you do use it to track progress, would you anticipate someone’s clinical profile to change over time?.”
Answer:
RJ Elbin, PhD: “Yes. We are currently using it to track progress. We’re using it as I said before, serially. So, we’re measuring it, we’re putting the CP screen into retest protocols and we’re doing it at every single clinical visit. So a week, to week and a half, two week follow-ups. And Dr. Pardini, I know you and I were both at University of Pittsburgh, and really kind of at the Genesis of all this, but I’ll speak from a researcher here, this whole idea in one of the slides talked about just trying to think of clinical profiles as, you know, what’s the primary or the chief complaint, what’s the primary profile. That was that overlapping piece, right? What’s the primary profile, what’s the secondary, and tertiary.
Now, what’s interesting is, if you think about what we know about symptom presentations with concussion, and this was the factor analysis paper that was published back in 2012 by Dr. Kontose and I, when I was a post-doc actually, we found that during that first week or those first five to seven days, everyone feels pretty crummy. We kind of conceptualize that as a global factor. The question that I have about using clinical profiles is when do we really hone in on determining a profile?
Do we need to wait until the fires have kind of calmed down a little bit? And some symptoms have resolved, some symptoms hang on right? So there are lots of things that can look like concussion acutely following this injury. The patient didn’t eat breakfast, didn’t drink enough water, dehydrated, all these things, right? And then acutely following concussion, you have the mess. And then maybe outside of that, there’s been kind of talks amongst my colleagues and I about when is the appropriate time to really apply these profiles and start to hone in, there are some clinicians out there that do it right away. If you’re doing it right away, we know that symptoms change. So it wouldn’t surprise me that symptoms wouldn’t change. And the profiles wouldn’t shift, maybe your primary falls off the map.”
Jamie Pardini, PhD: “Once you get sleep under control.”
RJ Elbin, PhD: “Exactly. Yeah. And sleeps no longer an issue. And then maybe we were just hanging on. You have a chronic patient and everything seems to point to anxiety. Maybe that’s not even concussion anymore.”
Jamie Pardini, PhD: “Right. And someone did also ask, can you use it in patients who have like persisting symptoms, which I would say absolutely.”
RJ Elbin, PhD: “Yeah, I agree.”
RESOURCES & LINKS:
FACULTY:
R.J. Elbin, PhD
Dr. R.J. Elbin is an Associate Professor in Exercise Science at the University of Arkansas and is director of the Office for Sport Concussion Research. Dr. Elbin’s research focuses on 1) examining the neurocognitive, physical, and psychosocial effects of sport-related concussion in youth and adolescent populations; 2) identifying factors that influence risk and recovery from sport-related concussion; and 3) documenting best practices for the clinical assessment, management, and treatment of concussion. Dr. Elbin has authored/co-authored more than 80 peer-reviewed publications and 150 professional presentations on sport-related concussion. Dr. Elbin was a 2018 recipient of an Early Career Award from the Sport Neuropsychological Society for his work in concussion research.
Jamie Pardini, PhD
Dr. Jamie Pardini is a Neuropsychologist and Clinical Associate Professor at the Sports Medicine and Concussion Specialists division of Banner University Medical Center-Phoenix. Prior to arriving at Banner, Dr. Pardini was Assistant Professor and Neuropsychologist for the Department of Neurological Surgery at the University of Pittsburgh Medical Center. She began her post-doctoral fellowship and academic career at the University of Pittsburgh Medical Center Sports Medicine Concussion Program, where she spent more than 9 years working solely with sport-related concussion and mild traumatic brain injury, managing the care and return-to-play of thousands of athletes.
