Brain domains - improving standards for brain injury rehabilitation.

concussion Mar 16, 2023

We've been very busy!

Yes, I was on national telly!

on the radio

& Keynote speaker at Sports Medicine South Australia

and why?



Concussion is headlining news nearly every day. Most of the news is unfortunately focusing on the negative & sometimes devastating effects of concussion. However, I have been promoting a proactive approach based on multimodal assessment and best practice rehabilitation.

We have been advocating for better management of concussions by outlining an inclusive evidence-based end-to-end model of care.

We have been tackling this via 3 organisational strategies.


Advanced Neuro Rehab has a history of post-concussion assessments and rehabilitation with a strong focus on Multimodal assessment, treatment & referral - transdisciplinary working.


Advanced Neuro Education has some upcoming online courses.

For parents, teachers and coaches – ‘Concussion, what you need to know’

For health professionals – ‘Comprehensive Management Course’


Your Brain Health is about advocacy, community awareness, baseline screening, global collaboration, community of practice and research.


So we are well and truly immersed in concussion!

But with all this positive promotional work about concussion, we really need to drag traumatic brain injury into the same conversations.

What do we mean by Multimodal? This is when we consider a wide range of domains that can be effected by head injury.

In physio we look at a collection of these domains

  • Balance, Gait and coordination
  • Vestibular
  • Some ocular movements
  • Cervical spine, especially whiplash injury and associated symptoms.
  • Exercise tolerance and autonomic functions.

But we also screen extra domains with a readiness to refer to our professional colleagues.

  • Emergency Department
  • Neurological
  • Sleep
  • Anxiety
  • Depression
  • Ocular movements
  • Autonomic dysfunction
  • Cognitive changes
  • Auditory processing
  • Musculoskeletal injury

Now, this proactive transdisciplinary and multidisciplinary approach that encourages a detailed look into each domain is very helpful in concussion, and with persistent symptoms this form of detailed assessment and management is critical.


But unfortunately, we review people with more severe traumatic brain injury and often find that detailed assessment has not always occurred! For example, vestibular, cervical, and ocular assessment have been overlooked during months of rehabilitation. How does this occur? This is a discussion topic that will come up in our next podcast because it is worth exploring, in addition to the whole way we look at persistent symptoms.


Until then!







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