SMART Concussion Trial: Symptom Management vs Alternative Randomized Treatment of Concussion Trial

Exclusion Criteria

• •Inability to communicate orally and/or in writing in English language
• •Significant developmental delay or intellectual disability
• •No access to smartphone or computer
• •Red flags or other clinical indication suggesting that further medical investigation is warranted (e.g., neurological scan - reflexes, dermatomes, myotomes, long tract signs, CN II-XII, Cerebellar Scan
• •Unresolved Benign Paroxysmal Positional Vertigo (BPPV) (Dix-Hallpike and Roll Test)
• •Inability to participate in physical activity for a reason other than concussion
• •Orthopedic or other injury precluding ability to participate
• •Medical history of neurological conditions: seizures (febrile SZ will be allowed), stroke, previous moderate/severe TBI, CNS cancers, SCI
• •Psychotic disorder
• •Inability to provide informed consent
• •History of surgery in the occipital region
• •Uncontrolled rheumatologic, inflammatory, or neurologic disorders (eg MS); Fibromyalgia/chronic fatigue syndrome; coagulopathy; immunosuppression
• •Active cancer
• •Herpes zoster infection in last 6 months
• •Pregnancy
• •Steroid injection to the greater or lesser occipital nerve infiltration in past 3 months
• •Previously enrolled in the trial