Dispatches from the Concussion Field: ACRM'S Revised Mild TBI Diagnostic Criteria and CARF International's New Concussion Rehabilitation Program Accreditation Standards
Christopher Giza1, Gerard Gioia2, Michael Yochelson3, Terrence Carolan4
1UCLA, Depts of Pediatrics and Neurosurgery, 2Children's National Hospital, 3Shepherd Center, 4CARF International
Objective:
To provide education on two new resources available to the field to enhance the care provided to individuals with lived experience of concussion.
Background:
The Mild TBI Task Force of the American Congress of Rehabilitation Medicine has recently updated the diagnostic criteria for mild traumatic brain injury (mTBI). This discussion will provide an overview of these activities and present the consensus diagnostic criteria for mild TBI.
CARF International has worked with the field to create the first Concussion Rehabilitation Program standards, which support the return of individuals to participation in their life roles, including, but not limited to, return to school, return to work, and return to sport. By promoting interdisciplinary, evidence-based, and person-centered care, these standards will promote self-management, self-advocacy, and prevention of future concussion.
Design/Methods:
ACRM's revision of the Mild TBI Diagnostic Criteria included rapid evidence reviews, an expert survey (to rate the diagnostic importance of clinical signs, symptoms, test findings, and contextual factors), public and stakeholder engagement, and a Delphi consensus process with an international, interdisciplinary panel of clinician-scientists. The creation of CARF's Concussion Rehabilitation Program Standards included interviews with different types of stakeholders across the field including persons served, providers, payers and others. An international, interdisciplinary committee created draft standards which were shared during a public field review and that feedback was integrated into the final Concussion Rehabilitation Program standards.
Results:
ACRM's revised Mild TBI Diagnostic Criteria were published in 2023 and are available to the public, and CARF International's Concussion Rehabilitation Program standards are part of the 2024 CARF Medical Rehabilitation Standards Manual and will be available for accreditation beginning July 2024.
Conclusions:
These two resources can be used to improve the identification of individuals with concussion and also provide guidance on how Concussion Rehabilitation Programs enhance the lives of individuals with lived experience of concussion.