Big hit: CHEO researcher develops post-concussion tool for kids

Dr. Roger Zemek, Scientist, Children's Hospital of Eastern Ontario and associate professor, University of Ottawa

Seeing stars? New tool developed at CHEO decodes the constellation of symptoms signalling brain injury and accurately gauges recovery time

March 22, 2016

Concussion is the most common traumatic brain injury in children and adults.

There is nothing simple about a concussion. The amount of energy required to heal a brain injury places massive demands on the body as it redeploys energy to the brain, allowing it to consume what it needs to heal. This often leaves the patient with depleted energy reserves, and many are unable to carry on their normal day-to-day activities.

In 2015 alone, Dr. Roger Zemek and his colleagues at the Children's Hospital of Eastern Ontario (CHEO) treated almost 1,000 children for concussion. That is about three children per day arriving in the emergency room with head injuries, ranging from mild to catastrophic.

Dr. Zemek is a pediatric emergency physician and research scientist with CHEO's Research Institute and an associate professor at the University of Ottawa. He believes that every concussion is different and every child recovers differently.

The challenge for the attending physician is to be able to accurately manage recovery expectations for children who are anxious to resume their active lifestyle, while balancing worried parents' concerns.

30,000 concussions or related head injuries are reported annually among 12- to 19-year-olds and 66% of those concussions are related to sports activity.

Source: Statistics Canada

It is important to recognize that the brain is a part of the body like no other. It is the body's central processing unit and, according to Dr. Zemek, rattled brains need time to heal. Just how much time was unclear, until recently, as few tools were available to physicians to help them assess recovery time.

It was this obvious need that inspired Dr. Zemek and his colleagues to conduct the 5P Study, Predicting and Preventing Post-concussive Problems in Pediatrics, which actually began in 2011.

Dr. Zemek was awarded a CHIR Team Grant to gather a network of researchers from across North America and bring them to Ottawa to design the methodology used in the 5P Study, the largest of its kind in the world.

CIHR then provided additional funding to support a comprehensive study which involved 3,000 children who were treated in one of nine participating pediatric emergency departments located in hospitals across Canada. This allowed the research team to gather the data required to build the predictive tool.

"CIHR funding has been essential to the success of the 5P study. Without it, I would never have been able to get to where we are today. Thanks to our CIHR grant, I could bring the best experts in the world to Ottawa in order to figure out how to develop and design the study."

Dr. Roger Zemek

Today, using Dr. Zemek's clinical prediction scoring tool, the attending physician can run the child through a series of simple questions and physical tasks that gather the information needed to gauge the impact of the concussion on the various systems in the body that are controlled by the brain.

Based on the patient's responses and the physician's observations, the score card is completed and tallied, and the severity of the injury is assessed.

The benefits of this groundbreaking advance are two-fold: kids with more serious cases of concussion receive the treatment they need more quickly, and doctors are better positioned to accurately predict the length of recuperation time required.

The 5P Study, which was recently published in JAMA, the Journal of the American Medical Association, is gathering international acclaim and growing CHEO's reputation as a leading pediatric health research institution.

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