title: Active rehabilitation for children who are slow to recover following sport-related concussion.
abstract: OBJECTIVE
  To present an innovative approach to the management of children who are slow to recover after a sport-related concussion.
  
  
  METHODS
  The article describes the underlying principles and the development of specific interventions for a new rehabilitation programme as well as preliminary data on pre- and post-rehabilitation changes in outcome measures.
  
  
  METHODS
  Development of the intervention was done using multiple perspectives including that of the literature, of experts in the field of traumatic brain injury and of experienced clinicians involved with the paediatric and adolescent MTBI clientele. A logic model was developed providing sound theoretical background to the intervention. The intervention was implemented and evaluated with a sample of 16 children and adolescents.
  
  
  RESULTS
  The presented cases suggest that involvement in controlled and closely monitored rehabilitation in the post-acute period may promote recovery in children and adolescents who present with atypical recovery following a concussion. All 16 of the children and adolescents who participated in the programme experienced a relatively rapid recovery and returned to their normal lifestyles and sport participation.
  
  
  CONCLUSIONS
  A gradual, closely-supervised active rehabilitation programme in the post-acute period (i.e. after 1 month post-injury) appears promising to improve the care provided to children who are slow to recover.
authors.affiliation: Montreal Children's Hospital, Montreal, Canada. isabelle.gagnon8@mcgill.ca
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gagnon
authors.forename: Carlo
authors.initials: C
authors.lastname: Galli
authors.forename: Debbie
authors.initials: D
authors.lastname: Friedman
authors.forename: Lisa
authors.initials: L
authors.lastname: Grilli
authors.forename: Grant L
authors.initials: GL
authors.lastname: Iverson
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D001924:Brain Concussion / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D015397:Program Evaluation; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D013997:Time Factors