The project, called Transcendent, is a $5.4-million research collaboration between the CHEO Research Institute, 360 Concussion Care and the Ontario Brain Institute.
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Published Nov 14, 2023 • Last updated 4 hours ago • 4 minute read
Dr. Roger Zemek has never forgotten a conversation with an upset father in CHEO’s emergency department more than a decade ago.
The man’s son had just suffered his sixth concussion. The first five happened while the youth was playing hockey, a sport he had to give up. The sixth was from a fluke accident in their home. The father was upset and angry because his son had another concussion after quitting hockey.
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He asked when his son was going to get better and Zemek replied, “I don’t know.”
The dad responded: “’You don’t know because you are an idiot or you don’t know because science doesn’t know?” When Zemek told him that science didn’t know, the father looked at him and said, “You’d better get on this.”
That is among stories that have helped shape Zemek’s career as a leading concussion researcher. The pediatric emergency physician and senior scientist at CHEO has conducted extensive research and helped develop guidelines on concussion for pediatric patients and families. He conducted the largest pediatric concussion study in the world to date, looking at predictors for persistent post-concussion symptoms in children with concussions. Those predictors, known as 5P, are now embedded at CHEO and other pediatric emergency departments. Most recently, Zemek led a study that found getting children back to school sooner after a concussion could speed their recovery.
Today, an emergency physician at CHEO would have an answer for that father about when his son was likely to get better.
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“I took his feedback to heart,” Zemek said Tuesday. “It has been my journey over this past decade.”
Zemek is leading a project that will address critical gaps in research about concussions for all age groups by establishing one of the world’s largest concussion data sets based on age, gender, mechanisms of injury and co-morbidities. Among other things, it will allow for individualized recovery plans.
The project, called Transcendent, aims to transform concussion care globally.
It is a $5.4-million research collaboration between the CHEO Research Institute, 360 Concussion Care and the Ontario Brain Institute, which aims to advance treatment and research for affected patients across the spectrum. Among other things, it will help identify indicators to track concussion recovery. That includes using biomarkers found in saliva and blood to eye-tracking and other physiological evaluations to neuro-imaging to better understand concussions and what treatments work.
The plan is to advance knowledge, treatment, investment in better concussion care and, eventually, enable individual treatment plans for patients, Zemek said.
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Transcendent was launched Tuesday at 360 Concussion Care, the evidence-based concussion, assessment, treatment and rehabilitation program based at the RA Centre in Ottawa as well as in Toronto and Burlington, Ont. Zemek is the program’s scientific director.
Concussion is the most common brain injury, affecting 400,000 Canadians each year, but much of the research has focused on high-performance or professional athletes and military veterans. That has restricted potential of new discoveries and work developing individual recovery plans.
Ottawa freelance television camera operator Sarah Boteler is among those who have benefitted from advancing research into concussions, and she is excited to see a focus on closing gaps in knowledge.
She had to retrain her brain after suffering from a severe concussion on the job more than a year ago, when she was hit in the head by a volleyball. She has mostly recovered after extensive treatment at 360 Concussion Care, but still has some lingering after effects.
Boteler also received a concussion a decade ago and says she has been amazed at how much has changed when it comes to treatment. Back then, she was told to go home and rest. This time, she received treatment from a neurologist, a physiotherapist, a social worker and an occupational therapist, among others, who helped treat physical and emotional symptoms and retrain her brain to be able to return to work.
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“I don’t know how I would have gotten through without that,” Boteler said.
Now, she said, research indicates it is better if people start doing things sooner and begin retraining their brains rather than spending more time resting in a dark room. She notes that concussion research has evolved quickly, but there are still unanswered questions.
“It is exciting to see continuing research to answer all of those questions.”
The program will make Ottawa a global centre of excellence when it comes to concussion research and care for everyone, research leaders said at Tuesday’s program launch.
Patients will play a key role in the research, Zemek said.
When he was working on the 5P research on predictors for post-concussion symptoms in children and youth, Zemek said he invited the father whose son experienced six concussions and other parents to help design that study. That same kind of patient engagement will be embedded in the Transcendent research program, he said.
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