Concussion Testing Online
If you suspect you’ve had a concussion, figuring out what to do for care is half the battle. Symptoms can come and go, and a quick Google search about concussion testing online often leaves you more confused. Understanding concussion testing online options is crucial for your recovery.
This article is designed to help you self-assess what’s wrong and figure out the best path forward. I hope it will simplify the search for relief and give you some best practices for recovering ASAP.
When considering care options, keep in mind that concussion testing online can provide valuable insights into your symptoms and recovery path.
Understanding the Importance of Concussion Testing Online for Your Recovery
New research has outlined three distinct phases of concussion recovery: rest, resuming light activity, and rehab. Below is an outline of how to move through each phase.
1: Rest
Rest is essential ONLY in the first 4-14 days of recovery. The brain is in a state of shock and needs peace and quiet to recover. Once you feel comfortable performing light activities around the house, move to step 2.
2: Resume Light Activity
This phase marks a gradual increase in activity. The best practice is the Buffalo Concussion Treadmill Test. It’s basically light cardio that gets progressively more challenging. Click this link for a video describing how to do it.
For comprehensive evaluation, consider utilizing concussion testing online services that provide professional guidance.
This test and protocol will help prevent prolonged autonomic symptoms and help identify stubborn symptoms that keep showing up during the test.
If you continually run into issues during this test, move to step 3.
3: Rehab
If you make it to this step, the process below will help you figure out what rehab you need. This is crucial because the rehab landscape is often very siloed and does not include all the forms of rehab you may need. Use it to guide your decision-making and choose the most appropriate form of care.
Initial Evaluation: History and Symptom Check
Try to recall the details of the injury.
-Where did it happen?
-When did it happen?
-Did you go unconscious?
-Can you remember the time before and after the injury?
If you can’t remember these details, take note and bring that information to your doctor’s appointment. Lapses in memory indicate a moderate to severe injury, and you should consult a medical doctor to ensure nothing dangerous has occurred.
Online Post Concussion Symptom Scale
Use the following symptom checklist to decipher which symptoms are the most problematic. The PCSS is widely used as a tool to objectively determine where you might need rehab. Mark your answers and then add up the total score.
Headache 0 1 2 3 4 5 6
Nausea 0 1 2 3 4 5 6
Vomiting 0 1 2 3 4 5 6
Balance problems 0 1 2 3 4 5 6
Dizziness 0 1 2 3 4 5 6
Fatigue 0 1 2 3 4 5 6 7
Sensitivity to light 0 1 2 3 4 5 6
Sensitivity to noise 0 1 2 3 4 5 6
Numbness / Tingling 0 1 2 3 4 5 6
Feeling mentally foggy 0 1 2 3 4 5 6
Feeling slowed down 0 1 2 3 4 5 6
Difficulty concentrating 0 1 2 3 4 5 6
Difficulty remembering 0 1 2 3 4 5 6
Drowsiness 0 1 2 3 4 5 6
Sleeping less than usual 0 1 2 3 4 5 6
Sleeping more than usual 0 1 2 3 4 5 6
Trouble falling asleep 0 1 2 3 4 5 6
Irritability 0 1 2 3 4 5 6
Nervousness 0 1 2 3 4 5 6
Feeling more emotional 0 1 2 3 4 5 6
Physical Examination
Below are some physical assessments that can tip you off that something needs attention/rehab.
– Pupil Assessment
Use a penlight to check pupils for size and reactivity to light.
When you shine it into one eye, your pupil should get smaller and stay smaller for some time. The opposite one should as well.
Look for differences in pupil size and the pupil’s inability to get smaller when you shine a light into it. This could indicate a more serious concussion, and you should get checked by a medical neurologist immediately.
– Balance Testing (BESS)
This is a reliable test to see whether or not you have balance difficulties.
You’ll need a foam pad or a pillow to stand on. Start on the ground with your eyes closed, standing usually. Stay balanced for 20 seconds, counting the number of corrections you need (a correction is taking your hands off your hips, operating your eyes, or stepping to keep your balance).
Perform the same test standing on 1 foot and standing heel to toe. Then, the same three tests were performed, but on a foam pad. Tally up the number of errors. If it is challenging to keep your balance, a vestibular specialist will help you recover. This can be a vestibular PT or a functional neurology provider.
Cerebellar Testing
Finger to nose: hold your arms straight out in front of you like Frankenstein. Close your eyes and touch the tip of your nose with your pointer finger.
If you miss your nose or have trouble finding it, take note.
Heel to shin test
Sit down and put your right heel on your left shin. Slowly move it down until it reaches the top of your foot. Do the same with the opposite leg.
If you can’t perform the test or there is jerky, uncoordinated movement down your spine, do not take it.
Rapid Alternating Movement
Hold your arms straight out in front of you like Frankenstein. Start with the palms up and rapidly alternate between palms facing up and pointing down.
Take note of any issues with sustaining that movement or if one side can’t seem to perform it.
Any issues with the above three tests may indicate cerebellar damage. To rule out anything serious, a medical consult is a good idea. If the tests come back clean, consult an OT or a functional neurology provider.
Vestibular/Ocular Assessment
– Smooth Pursuits: Hold a pen out in front of you and follow it side to side, up and down.
– What to Look For: Take note of any jerky movements, nausea, or headache that results from the test.
Saccades
Hold your thumbs out in front of you, about the width of your ears. Look back and forth between them rapidly for 10 seconds. Do the same thing vertically, holding your thumbs at the level of your forehead and chin.
What to Look For: Take note of any head or facial movement, nausea, or headache that occurs during these movements.
Convergence/Divergence
Hold a pen or something with tiny writing in front of your nose. Bring it towards your face, and try to stay focused on the letters. Then, follow it back out.
What to Look For: Note any eye strain, inability to keep the letters on focus, or feelings of disorientation during the test.
Accommodation
Hold your thumb before your nose. Look at your thumbs and rapidly switch your focus to something off in the distance. Repeat this for 10 as fast as you can.
What to Look For: Note any eye strain, difficulty performing the test rapidly, nausea, or feelings of disorientation.
If these tests cause discomfort or reproducing symptoms, you may benefit from seeing a vision therapy provider. They can provide specialized glasses to help you function daily and vision therapy exercises to help you rehab the dysfunction.
Note: If you have symptoms with these tests AND vestibular/balance problems, you may consider seeing a functional neurology provider before a vision therapist. In my experience, performing vision therapy with underlying balance problems is a recipe for disaster.
Cognitive Testing
Orientation Questions
– Procedure: Ask simple questions regarding the time, location, and personal details (e.g., “What day is it?”).
– Immediate Recall
– Procedure: Present 3-5 unrelated words; ask the person to repeat them immediately. Ex: fish, blue, house, scooter
– Scoring: 1 point per correct recall.
– Delayed Recall
– Procedure: After 5 minutes, ask the person to recall the same list.
– Scoring: Similar to immediate recall, with expected retention pointing to intact short-term memory.
Concentration Tasks
– Serial Sevens:
– Procedure: Start at 100, subtract seven repeatedly.
– Scoring: Monitor for correct answers, with mistakes suggesting concentration and working memory issues.
– Months in Reverse
– Procedure: Ask to recite months backward.
– Scoring: Note errors or hesitations.
-Dual Tasking During Gait
Procedure: Ask the person to walk normally. Please take note of their arm swing and lateral movement. Then, ask them to walk and say every other alphabet letter. Observe for changes in arm swing and coordination.
If you have issues with any of these, you may consider getting checked by a medical doctor to ensure nothing serious has occurred. If the tests come back clean, consider a neuro psych evaluation to address specific cognitive concerns.
Emotional and Behavioral Assessment
– Procedure: Use standardized scales (e.g., the Beck Depression Inventory) or observe directly for emotional problems. You can also tell relatively quickly if your mood has been low.
If you have had mood issues since the concussion, consider seeing a mental health professional to bolster your coping skills. Also, consider addressing other symptoms first. From clinical experience, I can tell you many emotional symptoms dissipate after other symptoms subside, especially depression and anxiety.
Conclusion
While this guide delivers a structured approach, it’s essential to keep accurate data on your symptoms and bring it to your medical providers. This information can save them time and ensure they can be treated effectively or referred appropriately.
If you have questions about concussion recovery, click here to schedule a complimentary consultation with one of our doctors. We’ve treated hundreds of complex neurologic cases and can help piece together the missing pieces in your recovery.
*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any remedies or therapies at home.
