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Post-concussion rehabilitation

After months of preparation, from summer camps to after-school practices and long hours in the weight room, it was time to kick off the 2019–2020 high school basketball season. On Nov. 19, 2019, just two days before the season opener, Joseph (Joey) Rembecki's team held an intense scrimmage where players were competing for their positions. But the much anticipated season of his junior year did not go as planned. During the scrimmage, as he approached the basket for a layup, another player who was set to take the charge knocked Joey's hip from under him. Joey fell hard to the floor, taking a direct hit to the back of his head.

Through an assessment by the team's athletic trainer, it was determined that Joey had sustained a concussion. While he didn't lose consciousness, he was dazed, confused and experiencing a lot of pain. After discussion with the athletic trainer, Joey's mother, Sarah Rembecki, who happens to be a pediatric nurse practitioner, decided to monitor his symptoms at home for a while.

Something wasn't right

Despite still experiencing some basic concussion symptoms (headache, feeling slightly dazed), Joey, a serious student, was determined to return to school right away. Within an hour of returning on his first day, however, his mother got a call to pick him up.

"This went on for a while," Sarah says. "We thought he was going to get better."

Statistically, 90% of those diagnosed with a concussion will return to normal activity on their own without medical intervention. However, as time went by, Sarah was becoming concerned that Joey might be part of the 10% who suffer post-concussion syndrome. The once straight-A student was now having difficulty focusing in the classroom, struggling with memory recall and experiencing exacerbated symptoms when exposed to crowds, loud noises and bright light. They knew it was time to get help.

What is post-concussion syndrome?

Symptoms of post-concussion syndrome can include visual problems, light sensitivity, nausea and vomiting, dizziness, attention problems, fogginess, fatigue, trouble sleeping, irritability, cognitive slowing, and balance issues. These symptoms can be helped through treatment by a rehab therapist who specializes in concussion management. Studies have shown that early initiation of physical therapy interventions have a positive impact at reducing these symptoms at a quicker rate than non-intervention.

Why Capital Region?

Initially, his primary care physician referred Joey to a concussion specialist in Columbia, MO, who then recommended vestibular therapy at MU Health Care. "For the number of treatments he was going to need, the frequent 30-minute drive to Columbia was just daunting with our schedules," Sarah recalls. "So, I quickly went on a fact-finding mission to determine if there was a care option for him closer to home [Jefferson City]. That's when I called Capital Region and was referred to Shari Kicker, MPT, at Healthplex West."

Getting treatment

Joey began his treatment at Capital Region Healthplex West on Jan. 20, 2020. The Rembeckis were immediately impressed with Kicker, who is a certified vestibular rehabilitation specialist. In his initial evaluation, she noticed right away what no one else had—Joey had convergence insufficiency, which means his eyes were not tracking correctly, specifically when objects were brought closer to him. This seemed to really explain many of his struggles at school.

After his initial evaluation, Joey and Kicker worked together through a customized therapy plan specific to his needs. He worked through aerobic conditioning, vision exercises, sports-specific multitasking and neck treatments. Kicker would also assign at-home exercises to boost his progress.

In addition to their therapy sessions, Kicker also worked with the school nurse to help Joey integrate back into his classroom routine.

"One of our biggest challenges was that it didn't look like there was anything wrong with him, so people didn't really understand how much he was still struggling. Shari was our biggest advocate for getting the appropriate accommodations for him at school," Sarah notes.

On to recovery

After 11 weeks of hard work in post-concussion rehabilitation, Joey is "back to baseline" and doing the things he loves. As his senior year begins, Joey is focused on getting safely back on the basketball court and enjoying his final year of high school.

Sarah says they couldn't be happier with the treatment Joey received. "We put all of our trust in Shari, and she was wonderful. [The staff] was always so upbeat that even if Joey was having a bad day, it was hard to leave therapy in a bad mood. Shari was really a lifesaver. That therapy changed his life."

Capital Region's multidisciplinary outpatient team is here to serve individuals who have sustained a concussion. Through individualized assessment and treatment, patients can minimize their symptoms and return to daily activity and life in a safe manner.

Questions about our post-concussion rehab program? Contact Shari Kicker, MPT, certified vestibular rehabilitation specialist, at 573.638.3400.

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