Q&A with Occupational Therapist Lisa Smith

Lisa Smith is a registered, licensed occupational therapist who leads the Mizzou Therapy Services concussion treatment program. She explains the steps to take if you or a loved one might have suffered a concussion and the treatment provided by MU Health Care.

What are the warning signs that someone has suffered a concussion?

Symptoms that may occur immediately following trauma to the head are a loss of consciousness, blurry or double vision, headache, nausea, vomiting, amnesia surrounding the event, confusion, drowsiness, feeling “foggy” and balance problems. Other symptoms including difficulty concentrating and remembering or emotional changes may not be noticed for days or months after the injury or until the person resumes their everyday life. Sometimes people do not recognize or admit that they are having problems. Others may not understand their problems and how the symptoms they are experiencing impact their daily activities.

What is the first step to take if you believe you or a family member has suffered a concussion?

Seek medical attention immediately. A concussion is considered a mild brain injury, as the brain is forced against the inside of the skull due to a traumatic event. Emergency medicine providers are trained to diagnose concussions and rule out a potentially more serious injury. If a concussion occurs during sports practice or a game, immediately stop playing and inform the athletic coach or trainer.

What are the dangers of not seeking treatment?

An undiagnosed concussion can put someone at risk for brain damage. Ignoring your symptoms and trying to “tough it out” often makes symptoms worse.  A concussion is a mild brain injury and can have lasting effects. If symptoms are not managed early, you can be at risk of developing post-concussion syndrome (PCS), which is a collection of symptoms including physical, emotional or behavior, and mental-processing difficulties. Most symptoms resolve themselves within two weeks to a month, but some can linger for several months.

What services do you offer in treating concussions?

At Mizzou Therapy Services, we offer a multidisciplinary approach, including physical, occupational and speech therapy services. We provide a holistic treatment approach that can address pain, balance problems, weakness, thinking difficulties, vision problems and ability to return to previous life roles, such as school or work activities. We work closely with the Physical Medicine & Rehabilitation clinic and frequently consult neuropsychology and eye-care professionals as needed.

Do you specialize in any particular area of concussion management?

As an occupational therapist, my main goal is to return clients to all of their previous life roles, including personal care and home management, productive activity such as work or school and leisure interests. Frequently, a concussion can cause difficulties with thinking abilities and functional vision needed for reading and visual processing. It is estimated that greater than two-thirds of the brain has connections to the vision system; therefore, it is expected that most people will experience some level of injury that impacts vision skills. In OT, we can provide neurological vision rehabilitation services in conjunction with eye-care professionals.

How do you determine when someone who has suffered a concussion is ready to return to daily activities?

It is largely based on symptoms. Initially, the person may need to stay home from school or refrain from work activities for one to two days and then gradually increase activity as tolerated. Complete cognitive and physical rest is no longer recommended. Light physical activity such as walking can be performed as soon as it can be tolerated.

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