Concussion evaluation and treatment program in Montreal

Concussion protocol at Cappino West Island

Cappino is a Sports Medicine Clinic in Montreal Accredited with a Concussion Protocol. CAMP is a multi-disciplinary concussion management organization that implements a unique return to LEARN system before a traditional return to PLAY system. It protects individuals of all ages and levels from the cognitive consequences of concussions. It is based on the reACT Program, developed by Ronny Varga (Physiotherapist) and Dr. Scott Delaney (Head Physician for the Montreal Alouettes).
The foundation of CAMP is based on a thorough physical and cognitive evaluation which thereby classifies athletes with a specific level of impairment. This information enables the therapist to determine the level of learning that the athlete or student-athlete is able to properly manage (ie: if taking time off school is needed, if a reduced course load should be implemented, rest periods during the school day etc.) and when return to PLAY should be incorporated. CAMP’s return to PLAY system has a sports specific protocol in place that enables the athlete to return to sport symptom free:
  • The Concussion Attestation Program prevents, identifies and appropriately reacts to potential concussions
  • With Baseline Testing, the resulting data is valuable in determining the athletes pre-injury (ie: normal) level of cognitive and at times, physical functioning allowing for meaningful comparison following a post-concussion assessment using similar tests, thus allowing better concussion management and safe return to play or work
  • Multi-disciplinary post-injury management program that emphasizes the importance of return to LEARN before PLAY, following a concussion
Cappino is the first clinic to incorporate the NeuroTracker in our Concussion Protocol. The NeuroTracker measures and improves cognitive performance in sports and everyday activities. Extremely useful in baseline testing, assessing concussions and concussion recovery, it only takes 3-5 minutes and improvement rates for athletes are dramatic due to isolate cognitive stimulation and rapid brain development through neuroplasticity.

Government Legislation

We continue to actively align our Concussion diagnosis and management approach with the most recent government reports and legislation. This is important and we want to lead the front in establishing and continuously refining a protocol that is innovative and sets our sports partners apart from the rest in concussion rehabilitation.

Concussion Evaluation Protocol

From a cognitive perspective, clients are evaluated on their memory recall and emotional impact. Physically, cervical (neck) and thoracic (upper body) range of motion and strength are assessed to establish any deficits in motion and strength that might have occurred as a result of the head trauma. These findings are documented as they will need to be addressed from a treatment perspective. The individual nerves of the spine are assessed in order to determine their strength, sensation and reflex activity. The client’s visual system is also tested to see how their eyes are tracking both moving and stationary objects as well as their response to light stimuli. Following this, balance and hand & eye coordination are examined.
Based on the results of the cognitive, physical and neurological evaluations, as well as the client’s subjective symptoms ratings scale numbers, the patient is given a specific Cappino Concussion Scale (CCS) number which then determines their potential level for returning to learn and to play.

Return to Learn

Based on the Cappino Concussion Evaluation (CCE), the client is rated on a scale from 0-6 whereby 0 means that they are able to initiate play and 6 signifies that they are severely incapacitated by their concussion

  • Score between 4-6 considered to display “high symptoms”
  • Score between 2-3 considered to display “moderate symptoms”
  • Score 1 considered to display “low symptoms”
  • Score 0 considered symptom free

Based on this assessment, detailed guidelines are put in place, detailing activities that are permitted and what should be avoided (in school, during everyday activities and on the field).

Return to Play

Once the client has returned physically, neurologically and cognitively back to their baseline status and has been declared “asymptomatic”, they are permitted to begin one of two Return to Play Protocols (RTP):

  • The choice of the specific protocol to follow is based upon the length of time it took before the client’s symptoms resolved.

Our protocol is comprised of the 7 ReCharge principles

REMOVE

Everyone involved in the game (including sideline staff, coaches, players, parents and guardians) should be aware of the signs, symptoms and dangers of concussion. In the event of a suspected concussion the injured player should be removed from play or training immediately.

RETEST

Visit a concussion management provider for further assessment. If you have previously undergone baseline testing, repeat testing will demonstrate any areas that may be impaired due to the injury and will help guide management recommendations. If you have not previously undergone baseline testing, a follow-up assessment with a health care provider specialized in concussions is still highly recommended.

REACT

Schedule an appointment to see a Medical Doctor as soon as possible. It is not usually necessary to visit the emergency room unless your symptoms are severe and/or rapidly worsening.

RECOVER

Based on the results of the assessment, the clinician may recommend treatment. Type, duration and frequency of appointments will depend on the severity of the injury and the areas affected by the trauma.

RECUPERATE

Research has shown that the injured individual will benefit from visual, cognitive and physical rest immediately following the injury. The rest period does not generally exceed 72 hours though there are exceptions.

RETURN TO LEARN OR PLAY

It is important that the student return to school timely and safely. Once symptoms have subsided, the clinician will put together accommodation recommendations to facilitate the return to learn. It is important that the process be gradual and that the student is given the support and leeway they need to return successfully. Once the athlete is symptom free, the clinician will being the exertion protocol. Once the athlete has completed the first three steps of the Return To Play protocol they will need to see a medical doctor for clearance