Neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome

NeuroRehabilitation. 2020;46(2):167-180. doi: 10.3233/NRE-192966.


Background: Persistent Sport-Related Post-Concussion Syndrome is often diagnosed with any type of prolonged PCS symptoms. However, there are not specific diagnostic criteria for PPCS such that misdiagnosis often occurs. Further, the signs and symptoms of PCS overlap with other common illnesses such as depression, anxiety, migraines, ADHD and others. Misdiagnosis may lead to less than efficacious treatment, resulting in prolonged symptoms.

Objective: This article will review relevant evidence-based literature on PCS, pointing out the lack of a systemic diagnostic framework. It will also provide evidence that highlights the multiple conflicting findings in the literature. This article will posit the BioPsychoSocial framework as the best diagnostic framework for understanding the impact of concussions on the person and to generate individualized and personal interventions.

Methods: A narrative review of sport concussion-related articles was conducted, after extensive searches of relevant and non-relevant literature by each author, as well as articles recommended by colleagues. Articles varied from American Academy of Neurology Class I to IV for evaluation and critique. Class IV articles were reviewed, as there is much public misconception regarding sport and other concussion treatment that needed identification and discussion.

Results: Articles reviewed varied by quality of research design and methodology. Multiple symptoms, recovery patterns and rehabilitation treatment approaches are purported in the sport-related concussion literature. Current consensus data as well as the mixed and contradictory findings were explored.

Conclusions: Persistent Sport-Related Post-Concussion Syndrome is a topic of great interest to both professionals and the general public. There is much misunderstanding about the etiology, causation, diagnostic formulations, symptom presentation, prolonging factors and treatment involved in this syndrome. This article posits an individualized multi-system diagnostic formulation, examining all relevant factors, as generating the best interventions for neurorehabilitation of Persistent Sport-Related Post-Concussion Syndrome.

Keywords: Concussion; Post-Concussion Syndrome; biofeedback; mild traumatic brain injury; sport concussion.

Publication types

  • Review

MeSH terms

  • Anxiety / etiology
  • Anxiety / psychology
  • Anxiety / rehabilitation
  • Athletic Injuries / complications
  • Athletic Injuries / psychology*
  • Athletic Injuries / rehabilitation*
  • Biofeedback, Psychology / methods
  • Brain Concussion / diagnosis
  • Cognitive Behavioral Therapy / methods
  • Humans
  • Migraine Disorders / etiology
  • Migraine Disorders / psychology
  • Migraine Disorders / rehabilitation
  • Neurological Rehabilitation / methods*
  • Neurological Rehabilitation / psychology*
  • Patient Education as Topic / methods
  • Post-Concussion Syndrome / etiology
  • Post-Concussion Syndrome / psychology*
  • Post-Concussion Syndrome / rehabilitation*