Traumatic Brain Injury and Concussions

September 14 – 15, 2019


This course is a two-day advanced hands-on seminar focusing on effective identification and management of physical symptom sequella that may arise following a concussion or mild traumatic brain injury (mTBI). Through this course, participants can expect to further advance their knowledge of the complexities of the vestibular system and understand why knowledge of this system is paramount to the successful management of this diagnosis. Evidence and current practice patterns will be discussed and supported throughout the seminar.

The physical symptoms developing after a mTBI can follow many clinical trajectories, many of them mediated by or involved directly with the vestibular system. The International Consensus on Concussion in Sport suggests that rehabilitation of cervical, vestibular, oculomotor and autonomic systems can be an integral part of the recovery from a concussion. We will explore each of these dysfunctions, how to identify their clinical patterns and presentations, develop treatment paradigms and understand expected recovery outcomes and prognosis.

Sessions will focus primarily on mild TBI and we will cover a variety of pathologies that may arise as a result of a TBI. These include diffuse axonal injury, metabolic changes following a concussion, skull fractures, fistulas, post- traumatic Ménière’s, whiplash, cervicogenic dizziness, BPPV, central or peripheral vestibular dysfunction, cranial nerve damage, sensory integration defects, autonomic dysregulation and balance and gait deficits. We will discuss the current “return to play” guidelines, their limitations, and gaps in research.

This course is organized to build in skill development through case presentations, guided lab, video examples, and lectures to allow the learner to have a thorough understanding of how to systematically manage this population without getting overwhelmed. We will provide the participant with a clinical algorithm to follow based on the most current evolving evidence. Participants will be able to develop a clear concise treatment regimen, learn how to educate the patient, their family, coaches and other medical professionals on expected recovery, and “return to play” guidelines based on the best current evidence available. Finally, participants will learn what is known in the literatures, what is not known and how you as a health care provider can play a prominent role and be an advocate for normal recovery.

  • Describe the core features and overlap of symptoms from mild traumatic brain injury to post-concussion syndrome protracted recovery, expected outcomes and literature updates.
  • Identify possible barriers to rehabilitation following a concussion and how to address them to maximize outcomes in the most efficient, cost-effective manner.
  • Identify the areas of possible damage to the vestibular system following a mTBI or concussion.
  • Identify how to choose the most appropriate tests to differentially diagnose vestibular and balance deficits following TBI.
  • Describe the tools used for balance and vestibular interview and evaluation and apply it to this complex population.
  • Evaluate the visual system (pursuits, saccades, vergence, and alignment) & understand how to integrate findings into the treatment plan.
  • Describe how to effectively manage whiplash associated dizziness.
  • Identify patterns and clinically relevant finding for a variety of pathologies that may arise following a TBI including central and peripheral vestibular deficits, skull fractures, fistulas, cranial nerve damage, visual dysfunction, post-traumatic Meniere's, headaches, migraines, whiplash, sensory integrations defects, balance and gait dysfunction.
  • Develop individualized treatment plans for cervical, vestibular, ocular and autonomic clinical trajectories post-concussion.
  • Describe the effects of multi-sensory damage and the importance of interdisciplinary management, including when to refer out.
  • Develop programs that incorporates “return to play” guidelines in a more useful, clinically relevant manner.
  • Describe how technological advances can help in your clinic and how to utilize low-cost evaluation and treatment tools.Upon completion of this course, participants will be able to:


Texas Children's Hospital
Feigin Center
1102 Bates, 14th floor conference room D
Houston, Texas 77030

Cost -  


Earned credits -  

Certificates of attendance for CEU verification are provided after successful completion of the course. This course is 15 contact hours /1.5 ceu’s/15 ccu’s This course is 18 contact hours/1.8 ceu’s for therapists licensed in Illinois, New York, or the District of Columbia

BOC Provider #P2047 |IL PT # 216000074 FL OT provider #50-1442 | AOTA Provider #4487

This course is applicable for PT, PTA, OT, AT’s. This course meets the continuing education requirements for physical therapists in the States of AK, AL, CA, CO CT, DE, DC, GA, ID, IN, MA, MO, MT, NH, NC, OR, PA, RI, SC, UT, VT, VA, WA, WI and WY. NAS is a provider for continuing education approved by the IDPR for physical therapists, IL provider # 216000074. This course meets the standards set forth in section 1399.96 of the California Code of Regulation and is approved for 15.0 hrs, 1.50 CEU’s for physical therapy continuing competency license renewal requirements in the State of California. This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider # 1907038TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas for 15 ccu’s. The assignment of Texas PT CCU’s does not imply endorsement of specific content, products, or clinical procedures by TPTA or TBPTE. This course meets the Colorado Physical Therapy Board of Examiners criteria for 15 ccu’s, 15 Category-1 PDA units. The New York State Education Department, Office of the Professions has approved NAS as a continuing education sponsor for physical therapists and assistants licensed in New York. North American Seminars, Inc. is an AOTA provider for continuing education. Provider # 4487. Advanced Level Occupational Therapy Process: evaluation, intervention. AOTA approval hours-15. The AOTA does not endorse specific course content, products or clinical procedures. The AK, AR, DE, DC, IL, IN, KY, LA, MD, MN, MS, MO, MT, OH, OR, OK, PA, RI, SC, TN, TX, VT and VA occupational therapy regulatory boards accept courses presented by AOTA providers to meet the needs of OT continuing educational requirements. Additionally, this course meets the ceu requirements for OT’s licensed in AL, AZ, CA, CO, CT, FL, GA, HI, ID, KS, ME, MA, MI, NE, NJ, ND, UT, WA, WV, WI and WY. FL OT provider # 50-1442. BOC provider # P2047, 15 hrs, category A, call for evidence-based approval status. Meets the NBCOT requirements. Don’t see your state listed? Call 800-300-5512 for specific state approval numbers as they are continually updated.


Karen Skop, PT, DPT, MS graduated in 2000 from University of Miami with her Master’s in Physical Therapy, 2008 from Temple University with her Doctorate in Physical Therapy. During her coursework at the University of Miami (UM), she studied under world-renowned Dr. Susan Herdman, completing the first of 4 “Vestibular Rehabilitation” competency course work while still a student. She was also able to have Dr. Herdman as her faculty advisor while completing research in providing visual feedback in individuals with vestibular loss. Since graduation, Dr. Skop has continued her work in vestibular rehabilitation helping “dizzy” patients of all ages from high school athletes to geriatric population. Primarily a clinical therapist she specializes in both the orthopedics and neurological population. She has worked within a multi-disciplinary team leading the rehabilitation efforts for various orthopedic & neurological clinics including Orthopedics, Sports Medicine, Parkinson’s, Stroke, Vestibular and Traumatic Brain Injuries (TBI). It is through this diversity of experience that positions her perfectly for the management of concussions and mild traumatic brain injuries (mTBI). She has published research on FIM data in stroke recovery, and continues to study the chronic effects of balance and sensory dysfunction in neuro-trauma. Dr. Skop is currently working on a variety of research/best practice for rehab in mild TBI and its effect on the vestibular system & knowledge translation from research to clinical practice. She currently practices for the Department of Veteran’s Affairs, leading a mTBI program which manages the post-concussive sequela following blast/blunt TBI and rehabilitation of the tactical athlete. Dr. Skop lectures for the Department of Defense and National Centers of Excellence, locally to residents and physicians to raise awareness and effective management of vestibular disorders. Dr. Skop part of the first taskforce of PT’s nominated by the APTA to disseminate clinical practice guidelines for vestibular rehabilitation and remains active within the SIG’s of the APTA. She serves as faculty for VA’s ABPTRFE Orthopedic & Neurological Residency program and continues to lecture as adjunct faculty for the University of South Florida.


Day One

  • 7:30 - 8:00 Registration
  • 8:00 - 9:30 Is This a Concussion or TBI?
    • Mechanisms for Injury-blast/blunt traumas
    • Co-morbidities that may impact care-PTSD, sleep, cognitive, migraine, pain, polypharmacy
    • Literature update-concussions, management, neurophysiological/metabolic changes and impact on the brain
  • 9:30 - 10:00 Anatomy and Physiology(Lecture) Review of CNS, CN, postural control refl exes, multiple sensory system impairments
  • 10:00 - 10:15 Break
  • 10:15 - 11:15 A Team Approach: Is it the Eyes, Ears, Neck or Brain? (Lecture)
    • Eye movements what to look for and when to refer to a specialist
    • Audiological testing- Interpretation from a rehab therapists perspective
    • Whiplash associated disorders-association with neck pain, headaches and dizziness after head injury
    • Multisensory & psychological considerations-prioritizing treatments
  • 11:15 - 12:00 Why Am I Dizzy? (Lecture/Demo)
    • Key questions for differential diagnosis
    • Group case study demonstrating importance of an accurate subjective exam-video analysis and discussion
  • 12:00 - 1:00 Lunch (on your own)
  • 1:00 - 3:45 Examination/Assessment Tools (Lecture/Lab)
    • Basic and advanced exam skills including detailed assessment of visual, vestibular system differential diagnosis of central versus peripheral pathologies (CN assessment, ocular misalignments, frenzel exam, aVOR, gaze stabilization, BPPV, balance testing, CTSIB, exertional testing)
    • Guided lab and hands on testing including video analysis
  • 3:45 - 4:00 Break
  • 4:00 - 5:45 Is There a Problem with the Neck? (Lecture/Lab)
    • Cervicogenic dizziness
    • Literature update-Lecture, lab skills acquisition
    • Cervical assessments-proprioception, orthopedic tests, head/neck differentiation, cervical flexion tests, neck torsion tests (guided-lab)
  • 5:45 - 6:30 Progressive Case Studies, Clinical Interpretation and Clinical Problem Solving (Lecture/Lab)
    • Guided analysis and interpretation of subjective and objective data
      • Utilization of ICF model and EBM
      • Case studies to include: complex clinical presentation of multimodal pathologies following head trauma-single or multiple events

Day Two

  • 8:00 - 9:00 Return to Play (Lecture/Lab)
    • Learn current guidelines and ACSM/AAN recommendations
    • Application and exercise prescription
  • 9:00 - 10:15 Differential Diagnosis and Exercise Prescription (Lec/Lab)
    • Exercise paradigms rationale behind adaptation, substitution, habituation,vision rehabilitation
      • Exercise prescription
      • Management of co-morbidities during rehab
  • 10:15 - 10:30 Break
  • 10:30 - 12:00 Cervicogenic Problems (Lecture/Lab)
    • Whiplash associated dizziness
    • Proprioception and kinesthetic training
    • Intrinsic muscle strengthening
    • Mobilization for headaches
    • Cervical dysfunction
  • 12:00 - 12:45 Lunch (on your own)
  • 12:45 - 2:30 Management of Central/Peripheral Pathologies (Lecture/Lab) • Differential diagnosis-building an appropriate treatment plan from prior case studies
    • Apply exercise prescription
    • Prioritizing interventions
  • 2:30 - 3:00 Clinical Tools and Clinical Integration
    • Do it yourself sans technology
    • There is an APP for that
    • Wrap Up Questions


Wyndham Medical Center
6800 Main
Houston, Texas 77030

  • Nightly rate: $115.00 (price varies based on room availability)
  • Reservations