Our Services

At Advanced Concussion Solutions we offer comprehensive baseline testing. The Center for Disease Control recommends comprehensive baseline concussion testing for athletes who participate in contact sports and those with a significant concussion history, learning challenges or a history of migraines.

In order to be effective, baseline testing should be multifaceted and include neurocognitive testing, oculomotor and balance testing as well as a baseline symptom score. Oculomotor and balance testing, and quantitative EEG (qEEG) analysis are some of the sophisticated baseline testing tools used at Advanced Concussion Solutions. A “map” of the brain function is obtained with qEEG which is particularly helpful in making accurate assessments and treatment decisions in athletes with ADHD, dyslexia or other learning difficulties. Our practitioners make the appropriate return-to-learn and return-to-play recommendations based on the baseline test results in close coordination with athlete’s teachers, coaches, and athletic trainers.

The eye movements are controlled by the oculomotor nerve. The nerve connects the eye muscles and controls important muscles including the pupillary muscle that constricts pupils, upper eyelids that control upward eye movement and the extraocular muscle that controls inward eye movement. Damage or concussion to this nerve can result in dilated pupils, blurry or double vision, headaches, eye strain and difficulty in reading among others which further delay the recovery time post-injury.

Our highly experienced concussion management experts at Advanced Concussion Solutions are well-versed in oculomotor testing that can reveal valuable information on the functioning of the brain post-injury. The vestibular oculomotor test is used by our concussion management experts to obtain highly reliable data that aids in optimum treatment outcomes.

Maintaining postural balance is one of the crucial functions of the brain which involves coordination of somatosensory, musculoskeletal, vestibular, and vision systems. In the event of an injury to any of these systems that are responsible for balance control, balance deficits, dizziness, vertigo, proprioception-related changes can be encountered. The National Athletic Trainers’ Association (NATA) and the National Collegiate Athletic Association (NCAA®) have identified balance testing as one of the most essential components of concussion management.

A set of other standardized balance evaluation tools to diagnose posture and balance related concerns to make treatment or return-to-play recommendations. These balance tests include:

• Rating the symptoms severity based on a scale of zero to five on The Motion Sensitivity Quotient which consists of testing sixteen different positions.
• The ABC Confidence Scale which assesses and rates the confidence of individuals in performing sixteen functions without losing balance.
• Dynamic Gait Index and The Berg Balance Test that evaluate the individual’s ability with respect to doing head turns at different speeds while walking around several obstacles.
• The Foam and Dome test or the Modified Clinical Test of Sensory Interaction on Balance which involves testing the patient on four movements, that is, standing on a surface that is firm with his or her eyes in open position and then closed and repeating this on the foam surface. Holding the position for thirty seconds each is the goal of these tests. Vestibular system concerns can become evident if there are difficulties with standing on the foam surface when eyes are closed.

These studies are used in conjunction with the oculomotor testing, vestibular assessment, and a range of motion studies to arrive at an accurate and reliable conclusion.

The Concussion Index (CI) assessment incorporates rapidly acquired EEG data, cognitive performance testing, and specific clinical signs/symptoms into a multimodal algorithm to objectively assess concussion, with the largest contribution from EEG features only.

The CI is expressed as an index from 0 to 100 with a lower score indicating greater severity of injury. The CI assessment can be used to longitudinally assess patients at baseline, injury, and recovery time points. Baseline assessment can be used to establish a patient-specific reference point to aid in evaluation of an injury at a later point in time. Following injury, the CI assessment can aid in clinical decision making at the time of injury, throughout recovery and when making return to play/activity decisions.

Our comprehensive concussion management includes state of the art testing and assessment that improve treatment outcomes and aid in making an accurate return to play recommendations. The SCAT5 or the Sport Concussion Assessment Tool is another standardized tool used by our expert medical professionals to screen concussions. The tool can be used as a baseline for following the injury and comprises of various steps ranging from obtaining the athlete’s background, symptom evaluation, cognition, concentration, and balance. SCAT-5 is highly valuable in assessing the following:

• Observable concussion signs
• Evaluation of symptoms
• Neurological screening
• Red flags
• Glasgow Coma Scale (GCS)
• Immediate, as well as delayed memory, following injury
• History of the athlete
• Assessment of the Cervical spine
• Cognitive screening

While a period of rest is important following an injury, a prolonged rest can be counterproductive, according to studies, and can negatively impact recovery. While concussions are known to impact cerebral blood circulation, excessive rest can lead to deconditioning, anxiety, and depression. Exercise tolerance tests are crucial components of getting athletes back on the road to recovery and re-conditioning.

At Advanced Concussion Solutions, our highly qualified and dedicated team of concussion experts excel in conducting subthreshold exercise testing to determine exercise tolerance levels. Using advanced and evidence-based subthreshold exercise testing tools such as the Buffalo Concussion Treadmill Test (BCTT), our concussion experts can evaluate the tolerance for varying levels of exercise in a graded manner. Our physicians advise patients on the optimal levels of exercise duration and intensity based on each unique tolerance level. The tests are used to recommend the levels of exercise that is optimal for each patient based on his or her tolerance levels. The graded protocols for exercise can aid in faster recovery besides helping athletes or non-athletes regain confidence in exercising.

We can consult on your college athlete when they suffer a concussion far away from home using telemedicine. Advanced Concussion Solutions has relationships with concussion experts nationwide and can often serve as a liaison helping to contact and consult with concussion experts in your child’s college town. Locally, Advanced Concussion Solution physicians are available on the weekends to serve as resource when your child suffers a head injury.