Dispatches from the Concussion Field: ACRM's Updated Mild TBI Diagnostic Criteria and CARF International's New Concussion Rehabilitation Program Standards

The diagnostic criteria for mild traumatic brain injury (mTBI) published by the American Congress of Rehabilitation Medicine (ACRM) in 1993 has guided clinical practice and research over the past 25 years. In 2019, the Mild TBI Task Force of the ACRM Brain Injury Special Interest Group began updating these diagnostic criteria. This work included rapid evidence reviews, an expert survey (to rate the diagnostic importance of clinical signs, symptoms, test findings, and contextual factors), public and stakeholder engagement, and a Delphi consensus process with an international, interdisciplinary panel of clinician-scientists. This panel discussion will provide an overview of these activities and present the consensus diagnostic criteria for mild TBI. The presenters will highlight the revisions from the 1993 definition and discuss their rationale and implications.

Concussions affect approximately 69 million individuals worldwide annually and result from a variety of causes. There is profound variation in the services provided by a Concussion Rehabilitation Program, and there is no international organization that assesses quality and performance improvement in the business and clinical practices of a Concussion Rehabilitation Program. CARF International has sought input from a wide spectrum of expert stakeholders, trade organizations and healthcare providers to create new Concussion Rehabilitation Program standards. These programs will provide interdisciplinary, evidence-based, and person-centered care that promotes self-management, self-advocacy, and prevention of future concussions. Concussion Rehabilitation Programs will also focus on the return to learn, return to work, and return to play, and the panel will discuss the practical application and relevance of these new standards.