Concussion treatment in Canada is coming up short, says new study

A report published in the Clinical Journal of Sports Medicine argues that concussion treatment in Canada needs to be regulated when it comes to providing healthcare services to patients with concussions, as the existing wide open field of service providers leaves it dangerously unclear whether or not patients using these services are currently receiving the treatment they need.

Authored by members of the Canada North Concussion Network, a multi-institutional research team in Manitoba focused on new research and treatment options for patients with concussion and traumatic brain injury, the report says that Canadians who try to conduct their own searches for concussion care providers are likely to encounter a range of options, some of which do not meet the medical standards for either evaluating or treating the often complex and multifaceted aspects of concussion, postconcussion syndrome (PCS) and traumatic brain injury (TBI).

Mimicking what any Canadian looking for concussion care providers would do, the reports authors went to Google and searched using the terms “concussion,” “concussion clinic” and the names of each of Canada’s provinces and territories. What they pulled out on the first ten services listed was not to their liking.

What these clinics and care centres did have were a multitude of professionals – chiropractors, osteopaths and massage therapists, for example – whose role in the treatment of concussion, PCS and TBI, according to the study’s authors, has not been medically established.

Most glaring were the omissions from the providers’ staff lists, as many did not list an on-site medical doctor or have access to sports medicine physicians. And although roughly two-thirds (67 per cent) of these clinics offered to conduct baseline neurocognitive testing, less than one quarter (21 per cent) identified a registered neuropsychologist as a member of their clinical team, even though guidelines suggest that only neuropsychologists have the advanced expertise needed to administer and evaluate these tests.

What these clinics and care centres did have were a multitude of professionals – chiropractors, osteopaths and massage therapists, for example – whose role in the treatment of concussion, PCS and TBI, according to the study’s authors, has not been medically established.

“Our study indicates that concussion healthcare in Canada is currently offered by a wide spectrum of professionals with varying levels of clinical training and experience in TBI … and who are operating without any national or international guidelines addressing the requisite training needed to participate in the multidisciplinary care of patients with a concussion.”

Each year about 40,000 Canadians are diagnosed as having suffered a concussion, which is defined as a mild form of traumatic brain injury caused by a blow to the head or body, often affecting proper brain functioning in the short and/or long term. According to the advocacy group Brain Injury Canada, the majority of concussions are treatable if diagnosed correctly and soon enough, with the main requirement being physical and mental rest until symptoms dissipate. For more moderate and severe cases, a variety of approaches are sometimes needed, including medications, surgery and rehabilitation.

Of special concern to the report’s authors was their finding that over 100 healthcare providers in Canada are currently operating under training by one of two private companies offering training and certification in concussion healthcare, while in fact neither of these companies has the status of nationally licensed training institutions.

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