Original Title: Reprise graduelle des activités à la suite d’un traumatisme craniocérébral léger ou d’une commotion cérébrale (TCCL/CC)

Authors' objectives: MTBI/concussion can cause a variety of symptoms, but in most people, these disappear within a few weeks. To optimize recovery and minimize long-term impact, a gradual approach to resuming activities is recommended. Information, education, and reassurance for people with such trauma are essential to the management of this condition. The INESSS has produced an information pamphlet designed to guide people with MTBI/concussion and their close ones in resuming intellectual, physical, and sporting activities. The pamphlet, last updated in 2018, is widely used in the Quebec healthcare network. It is recognized by people with MTBI/concussion, their close ones, and healthcare professionals as a reference tool for the management of MTBI/concussion. This project aimed to update the INESSS pamphlet for people with MTBI/concussion (school-age children, adolescents, adults, seniors) and their close ones. This update was necessary as new evidence and recommendations have been published.

Authors' results and conclusions: RESULTS: The literature review identified 33 scientific literature documents and 6 grey literature documents of varying quality. The information gathered in these documents was synthesized in the form of statements and submitted to an advisory committee made up of 21 people with diverse clinical, scientific, and administrative expertise. Most statements (13 out of 17) were kept as they reached consensus (≥ 80% agreement) in the final vote of the advisory committee. The four remaining statements were modified by eliminating the main source of disagreement, i.e., no mention of specific professions able to support people with MTBI/concussion. As a result, 17 statements were formulated and translated into an information pamphlet designed to help people with MTBI/concussion and their close ones gradually resume intellectual, physical, and sporting activities. (#1 CLINICAL POINT OF VIEW): The initial rest period is 1 to 2 days rather than at least 48 hours; • Initial rest is now described as “active” rest, meaning that the person continues to perform daily activities, but more gently, rather than limiting all activities; • Advice on possible activities during initial rest has been added in response to the need expressed by people with MTBI/concussion, since the 2018 pamphlet only mentioned advice on activities to avoid or limit; (#2 GRAPHICS & COMMUNICATION): The pamphlet now includes 4 pages (rather than 2 pages) to meet the need indicated by users to space the information further apart; • Throughout the pamphlet, several examples of activities have been added in an attempt to reach various clienteles - e.g., people who do not go to school or who do not participate in sports; • In response to the need for reassurance expressed by people who have suffered a MTBI/concussion, the section on additional resources has been expanded to better direct them to the appropriate resources; • A major effort has been made to adapt the literacy level to the target audience and make the information accessible to a large number of people. CONCLUSION: To get the desired impact, the pamphlet needs to be distributed within various professional orders and clinical settings, as some professionals may be less familiar with the MTBI/concussion pamphlet and the advice it contains. The pamphlet could also be distributed in non-clinical settings - e.g., sports associations, schools, workplaces, residential care facilities - to raise awareness among all people who may meet a person with MTBI/concussion. As traumas are not exclusive to the health sector, it will be necessary to establish links between various stakeholders, including the Quebec Ministry of Education and various sports associations.

Authors' methods: The process of developing the statements and producing the pamphlet on resuming intellectual, physical, and sporting activities included: 1. A review of the scientific and grey literature on information and advice for people who have just had a MBTI/concussion; 2. A synthesis of the information, analysis of the methodological quality of the documents, and formulation of a first draft of statements; 3. A consultation process (two electronic surveys and one virtual meeting) with an advisory committee of clinical, scientific, and administrative experts, in order to reach a consensus on the statements; 4. Finalization of the statements and their translation into an information pamphlet; 5. Two consultation processes (individual interviews) with pamphlet users, one at the beginning of the project to get their opinion on the 2018 pamphlet, and one at the end of the project to test the usability and acceptability of the updated pamphlet; 6. The production of a pamphlet for targeted users.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/traumatisme-craniocerebral-leger-conseils-pour-la-reprise-graduelle-des-activites-intellectuelles-physiques-et-sportives-mise-a-jour-du-depliant.html

Year Published: 2024

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/traumatisme-craniocerebral-leger-conseils-pour-la-reprise-graduelle-des-activites-intellectuelles-physiques-et-sportives-mise-a-jour-du-depliant.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)