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Keywords

Health Care Competency

Abstract

The physiological alterations in autonomic nervous system (ANS) function due to concussion are suggested to play a role in persistent post-concussion symptoms (PPCS). Currently, there are few objective and clinically feasible measurements to assess ANS vitality in patients experiencing PPCS. The following case study details an assessment and treatment protocol targeted towards regulating the ANS in an adolescent female suffering from PPCS one month after injury. Pre-intervention, patient-reported outcome measures (PROMs) used to assess perceived pain, anxiety, stress, and breathing function were administered as well as a physical assessment performed for breath function and vagus nerve integrity. The patient was then treated with an intervention designed to regulate the flow of breath and restore autonomic function by initiating a parasympathetic response. The patient was readministered PROMs immediately post-intervention, at 24 hours, and at one-week post-intervention to observe changes in autonomic function and resilience. Meaningful changes in PROMs at each follow up noted a downward trend in symptoms and perceived anxiety, stress, and breathing function, indicating less severe symptoms and increased autonomic resilience. The results of this case study encourage clinicians to consider the use of a multi-factorial assessment and treatment protocol for the autonomic nervous system in post-concussion management to assist in persistent symptoms post-injury.

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