Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Complementary Integrative Rehabilitation Medicine
Objective : Single Case Study of a young man debilitated by the accumulative effects of six-sports related concussions over a ten year period.
Design : Summarize each treatment, as each session revealed measurable positive improvements in specific symptoms. Ongoing medical records capture his progress through his journey of receiving these manual therapies. [Long term follow up is planned at 6 month intervals].
Setting : Outpatient private practice clinic in the Midwest. Private referral source.
Participants (or Animals, Specimens, Cadavers) : Convenience sample subject
Interventions : CranioSacral Therapy. Lymphatic Drainage, Myofascial Release, Glial and glymphatic release/drainage techniques. Clinical application is unique & improvisational in response to daily presentation of symptoms and body tissue responses.
Main Outcome Measure(s) : Concussion Symptom Checklist, Headache Impact Test - 6, and Quality of Life measurement. Used as Intake Data, and then to test outcomes. Scores showed extreme impact upon life.
Results : At the time of this writing, client has had 11 treatment sessions and has reported a 90-95% reduction in the number and/or severity of symptoms. Evidence was captured by periodic scores on the Post Concussion Symptom Checklist. Based on manual palpation at initial visit, it was determined that 75% of ribs were not expanding with breaths and rib cage was distorted and pulled anterior from spine. Oxygen saturation was significantly lowered but restored to 97-99% by the 2nd session following manual therapies to rib cage. Pupils were initially fixed and dilated and showed a 50% positive response following the first session; restored to normal specifically with sphenoid decompression technique. Significant edema was initially palpated at base of head and posterior neck. Fluids surrounding vertebral bodies were not draining. The sensation of head pressure and pain caused by the edema was reduced by 90% in 1st session, was exacerbated by future activity, but normalized after this treatment series. Manual lymphatic drainage was the treatment most effective in reducing headache and pressure pain. He slept through the night (12 hours) for the first time in 14 months after 1st session. Nausea abated by 2nd session. Suicidal ideation were the trigger for the family to seek help. Measurable positive effect or reduction in sensory, cognitive, physical, and emotional symptoms was obtained. A full elevation of his mood and restoration of hopefulness for healing emerged with each session.
Conclusions : Single case studies can highlight the individual nature of persistent and accumulative post-concussion symptoms. The non-invasive treatments used in this case treat the central nervous system directly and highlight the emerging science of a fluid model of human anatomy. Proper assessment of symptoms are aided by full body, manual palpation of all anatomical systems. Persistent symptoms from head injury or concussion may be in part due to stagnation and congestion of the lymphatics, cerebral spinal, and interstitial fluids. Fascia restrictions and osseous compression may be contributing to the fluid congestion. These therapies can be applied with measurable, positive results in a relatively short period of time and with a comparably low financial impact.
Susan Kratz– Clinical Director, Special Therapies, Inc., Waukesha, Wisconsin