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Barbara Baker, Eric Koch, Kevin Vicari and Kyle Walenta

during the postacute phase of SRC and (2) to assess the most effective intensity of exercise during the postacute phase of SRC. Methods Databases and Search Terms The CINAHL, PubMed, SPORTDiscus, and Web of Science databases were used to search the terms “brain concussion” AND “exercise” and variations

Open access

Ashley L. Santo, Melissa L. Race and Elizabeth F. Teel

Context: Convergence dysfunction following concussion is common. Near point of convergence (NPC) is a quick and easy assessment that may detect oculomotor dysfunction such as convergence insufficiency (CI), but NPC measurements are rarely reported. Convergence dysfunction is treatable in otherwise healthy patients; the effectiveness of oculomotor therapy following concussion is unclear. Objectives: The purpose of this article was to systematically review the literature and answer the following clinical questions: (1) Is performance on NPC negatively affected in patients diagnosed with a concussion compared with pre-injury levels or healthy controls? (2) In patients diagnosed with concussion, what is the effect of oculomotor/vision therapy on NPC break measurements? Evidence Acquisition: The search was conducted in CINAHL, SPORTDiscus, MEDLINE, and PubMed using terms related to concussion, mild traumatic brain injury, convergence, vision, and rehabilitation. Literature considered for review included original research publications that collected measures of NPC break in concussion patients, with a pretest–posttest comparison or comparison with a healthy control group. A literature review was completed; 242 relevant articles were reviewed, with 18 articles meeting criteria for inclusion in the review. Evidence Synthesis: Articles were categorized according to the clinical question they addressed. The patient or participant sample (number, sex, age, and health status), study design, instrumentation, or intervention used, and main results were extracted from each article. Conclusions: The authors' main findings suggest that there is a moderate level of evidence that patients have impaired NPC up to several months postconcussion, and a low level of evidence that impairments can be successfully treated with oculomotor therapy. These findings should be cautiously evaluated; the studies are limited by weak/moderate quality, small sample sizes, varied methodology, and nonrandomized treatment groups. Future research should explore factors affecting convergence postconcussion and include randomized, controlled studies to determine if performing vision therapy improves visual measures and promotes recovery.

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Jenna Ratka, Jamie Mansell and Anne Russ

ntervention/Assessment: mouthguard use • C omparison: no mouthguard use • O utcome: concussion incidence rates In addition, the following Boolean phrases were used: • concussion OR brain concussion [Mesh] • AND mouthguard OR mouth protector The criteria for study inclusion were as follows: • Relevance to the

Open access

Landon Lempke, Abbis Jaffri and Nicholas Erdman

potentially related to concussion recovery involving early physical activity and rest: (mtbi OR mild traumatic brain injury OR brain concussion OR cerebral concussion OR mild concussion OR moderate concussion OR severe concussion OR cerebral trauma OR minor head trauma OR mild head injury OR SRC OR src OR

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Michael Gay and Semyon Slobounov

). Study of learning and memory in guinea pigs suffering brain concussion . Federation Proceedings, 5 ( 1 ), 7 . PubMed Berchtold , N.C. , Chinn , G. , Chou , M. , Kesslak , J.P. , & Cotman , C.W. ( 2005 ). Exercise primes a molecular memory for brain-derived neurotrophic factor protein

Open access

Eric S. Rawson, Mary P. Miles and D. Enette Larson-Meyer

brain. Concussion (Mild Traumatic Brain Injury) Following a mTBI, brain creatine decreases ( Vagnozzi et al., 2013 ) and there is a hypometabolic state. These challenges to energy status could be mitigated through creatine supplementation ( Barrett et al., 2014 ; Dean et al., 2017 ). Additionally