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Program

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TIME SESSION INFORMATION
07:30-08:30 Registration & Continental Breakfast
08:30-08:45 Welcome "& Opening Remarks
Paul Comper, PhD, CPsych
Toronto Rehabilitation Institute, University Health Network
08:45-09:30 Mild Traumatic Brain Injury: Pathophysiology and Recovery

Christopher Giza, MD
Professor of Pediatric Neurology and Neurosurgery, UCLA Brain Injury Research Center; Director, UCLA Steve Tisch BrainSPORT: Sports Concussion - Mild TBI Program; Medical Director, Operation MEND-Wounded Warrior Project TBI Program. Interdepartmental Programs for Neuroscience and Biomedical Engineering, David Geffen School of Medicine at UCLA, Mattel Children's Hospital - UCLA
Learning Objectives
  1. Learn how basic neurobiology is altered following concussive injury
  2. Utilize this understanding to inform clinical management of concussions
9:30 – 10:15 The Differential Effects of Mild TBI on Neurocognitive Functioning: Why No Two ‘Mild’ Brain Injuries are the Same

Don Stuss, PhD
Professor, University of Toronto; Founding President and Scientific Director, Ontario Brain Institute (2011-2015)

There is a need for improved phenotyping (sub-classification) of patients with traumatic brain injury, since specific treatments may work only in certain groups of patients. Examples of heterogeneity amongst TBI patients will set the stage to describe one approach to understanding this heterogeneity – the lens of frontal lobe dysfunction.
  1. Recognize the presence of heterogeneity among patients with mild traumatic brain injury
  2. Differentiate four categories of frontal lobe dysfunction and their relation to specific frontal lobe regions
  3. Identify potential behavioural syndromes caused by TBI and relate them to the four frontal lobe functional categories
10:15-10:45 Morning Break, Poster and Sponsor/Exhibitor Viewing
10:45-11:15 Rapid Podium Presentations
The following six talks, chosen from the call for abstracts, will be presented in the main room for five minutes each.

Presentation 1
THE NEED TO STANDARDIZE CONCUSSION CARE: THE CONCUSSION AWARENESS TRAINING TOOL (CATT)

Shelina Babul, PhD
Associate Director, Sports Injury Specialist, BC Injury Research and Prevention Unit

Presentation 2
GOOGLING CONCUSSION CARE: A CRITICAL APPRAISAL OF ONLINE CONCUSSION HEALTHCARE PROVIDERS AND PRACTICES IN CANADA

Michael Ellis, MD FRCSC
Medical Director, Pan Am Concussion Program

Presentation 3
ONTARIO CONCUSSION CARE STRATEGY: STARTING WITH A COMMON LANGUAGE TO IMPROVE CLINICAL CARE AND RESEARCH

Cindy Hunt, DrPH, RN, MPH
Senior Research Associate, St. Michael's Hospital

Presentation 4
EFFICIENCY OF AN ACTIVE REHABILITATION INTERVENTION IN A PEDIATRIC POPULATION WITH ATYPICAL RECOVERY FOLLOWING A MILD TRAUMATIC BRAIN INJURY

Sarah Imhoff Kin, SCPE-PEC, ACSM-CEP
Institut universitaire de cardiologie et pneumologie de Québec; Université du Québec à Trois-Rivières

Presentation 5
BRAIN MAGNETIC RESONANCE IMAGING CO2 STRESS TESTING IN ADOLESCENT POST-CONCUSSION SYNDROME

W. Alan Mutch
Professor, Department of Anesthesia and Preoperative Medicine University of Manitoba

Presentation 6
ACADEMIC OUTCOMES IN HIGH-SCHOOL STUDENTS AFTER A CONCUSSION: A RETROSPECTIVE POPULATION-BASED ANALYSIS

Dr. Kelly Russell, University of Manitoba
11:15-11:20 Transition to Concurrent Workshop Session #1
11:20-12:20 Concurrent Workshop Session #1
The following four workshops will run concurrently from 11:20 am to 12:20 pm and again in the afternoon from 3:45 pm to 4:45 pm.
Workshops
11:20-12:20 Workshop #1
Practical Strategies for Return-to-Activities Following Sport Concussion

Michael Hutchison, PhD RKin
Assistant Professor, Faculty of Kinesiology and Physical Education, University of Toronto; Director, Concussion Program, David L. MacIntosh Sport Medicine Clinic

Concussion management guidelines have historically been developed and focused on the intent of providing guidance and direction for the medicine practitioner in making complex management decisions in returning to play. Although such guidelines have no doubt resulted in improved care of the athlete, there has historically been a void in a standardized process for managing the patient in other activities of life (i.e., work, school, and social). This workshop will address how to develop a practical framework and identify solutions for the gradual re-introduction of stressors in daily activates following concussion. This workshop will also highlight the role of exercise for those with persistent symptoms.

Learning Objectives
  1. Review the rationale and stages for return-to-play guidelines.
  2. Identify and discuss common stressors that should be considered in acute concussion management and return-to-activity progressions.
  3. Discuss the rationale and possible strategies for exercise as an intervention for those with persistent symptoms.
11:20-12:20 Workshop #2
Clinical Pearls in the Assessment and Management of Chronic Headaches Following a Traumatic Brain Injury

Jonathan P. Gladstone, MD FRCPC
Director, Gladstone Headache Clinic
Consultant Neurologist, Neurology Service & Complex Injury Outpatient Rehabilitation Service (WSIB Neurology Specialty Clinics), Toronto Rehabilitation Institute – UHN; Co-Director, Headache Clinic, Hospital for Sick Children; Director of Neurology & Headache Medicine, Cleveland Clinic Canada; Consultant Neurologist, Toronto Blue Jays & Toronto Raptors

Headache is the most common symptom following a mild traumatic brain injury. It is also the symptom that typically lasts the longest and is the most disabling. This workshop will address how to assess and manage individuals with persisting headaches following a traumatic brain injury. Common pitfalls in headache management will be discussed and strategies to facilitate successful management will be highlighted.

Learning Objectives
  1. Discuss the critical aspects of the headache history necessary to facilitate successful post-traumatic headache management
  2. Explore non-pharmacologic and pharmacologic strategies for the acute and prophylactic management of post-traumatic headache management
11:20-12:20 Workshop #3
Visual Disturbances Following mTBI/concussion – What the Health Care Provider Needs to Know

Paul J. Ranalli, MD, FRCPC
Neurologist, Neuro-ophthalmologist, Neuro-otologist, Humber River Hospital; Co-Director, Neuro-otology Clinic Toronto General Hospital (UHN); Lecturer in Neurology, Faculties of Medicine, Otolaryngology, Ophthalmology & Visual Sciences, University of Toronto

Recognized visual system injuries in concussion may affect any level of the afferent visual pathway (cornea, retina, optic nerve, optic tracts, visual radiations, occipital cortex) or the ocular motor system that directs vision to the target. We will learn how to recognize these injuries and sort them from recently popularized unvalidated syndromes and interventions that can interfere with the visual recovery of patients following concussion.

Learning Objectives
  1. Review the known acquired visual disturbances following mTBI/concussion
  2. Describe the controversies and myths
  3. Provide an overview of appropriate strategies and interventions for addressing post traumatic visual symptoms
11:20-12:20 Workshop #4
Challenges of Litigating Mild Traumatic Brain Injury

Session #1:
Jim Vigmond, Founding Partner, Oatley Vigmond LLP
Ryan Murray, Partner, Oatley Vigmond LLP

Session #2:Dale Orlando, Founding Partner, McLeish Orlando LLP
Alison Burrison, Partner, McLeish Orlando LLP

The diagnosis and etiology of mTBI are controversial in the courtroom. Clinicians and experts can have a profound impact on the juror’s perception of the injury, its treatment, and its consequences. This session will provide guidance on how the clinician and/or expert can be helpful to the patient/client’s claim for compensation.

Learning Objectives:
  1. Learn not to accept the patient’s history at face value
  2. Discuss the importance of examining the pre-morbid records
  3. Recognize co-morbidity and emotional influences and impairments
  4. Discuss the importance of documenting and charting properly
12:20-13:30 Networking Lunch Break, Poster and Sponsor/Exhibitor Viewing
13:30-14:00 Four Pillars of Recovery
Ron Ellis
Former NHL player and Advocate for Mental Health

As a professional hockey player, Ron Ellis accepted the possibility of physical injury to a shoulder or a knee; however, he never gave thought to a brain injury that would impact his life after hockey.
14:00-15:00 Dancing in the Dark: The Stuff I Have Learned from the Toughest Traumatic Brain Injury Cases and How to Manage Them

A Snaiderman, MD,FRCP (C)
Director, Neuropsychiatry Clinic, Brain and Spinal Cord Program, Toronto Rehabilitation Institute – UHN; Assistant Professor, Departments of Psychiatry and Medicine, University of Toronto

Learning Objectives:
  1. Through the use of clinical cases, gain perspective on the challenges treatment teams face when handling traumatic brain injuries.
  2. Develop strategies to deal with those challenges.
15:00-15:45 Afternoon Break, Poster and Sponsor/Exhibitor Viewing
15:45-16:45 Concurrent Workshop Session #2
Session 1 workshops are repeated again in session 2. See workshop descriptions at 11:20 am.
16:45-17:00 Closing Remarks
Paul Comper, PhD, CPsych
Toronto Rehabilitation Institute, University Health Network
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