Michael Fung

Publications (2)3 Total impact

• Source

  Available from: Barry Willer

  Article: Regulatory and autoregulatory physiological dysfunction as a primary characteristic of post concussion syndrome: implications for treatment.

  John J Leddy, Karl Kozlowski, Michael Fung, David R Pendergast, Barry Willer
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  ABSTRACT: Although most patients with concussion recover within days to weeks, a small but significant minority develop persistent signs and symptoms of post-concussion syndrome (PCS). The standard treatments of PCS, rest and cognitive adaptation, have limited effectiveness. PCS patients are advised not to exercise because of the concern for symptom exacerbation. Prolonged rest, however, leads to deconditioning (especially in athletes) and may cause secondary effects including depressive symptoms. Concussion is associated with metabolic and physiological changes in the brain and in other organ systems (for example, autonomic function of the heart and altered cerebral autoregulation, sleep, and circadian rhythms). We propose that PCS results from ongoing central and systemic physiologic regulatory dysfunction after traumatic brain injury (TBI) and we further propose that this physiologic dysfunction may be reduced or alleviated by individualized controlled sub-symptom threshold aerobic exercise rehabilitation.
  Neurorehabilitation 02/2007; 22(3):199-205. · 1.63 Impact Factor
• Source

  Available from: Barry Willer

  Article: A proposal for an evidenced-based emergency department discharge form for mild traumatic brain injury.

  Michael Fung, Barry Willer, Douglas Moreland, John J Leddy
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  ABSTRACT: To examine and compare a sample of head injury care instruction forms available in hospital emergency departments (EDs) against evidence-based factors predictive of haemorrhage or traumatic lesions and to propose an easy-to-understand discharge instruction form for patients with concussion or mild traumatic brain injury (MTBI). Fifteen hospital discharge instruction forms were reviewed for inclusion of six factors known to be associated with the presence of haemorrhage after MTBI. ED instruction forms were also evaluated for readability. The 15 hospital ED instruction forms varied in what patients' caretakers were instructed to observe. Some but not all important factors associated with haemorrhage were included. The mean Flesch-Kincaid reading grade level of the discharge instruction forms was 8.2 with a mean Reading Ease score of 59.9%. EDs use discharge instruction forms listing signs and symptoms that are highly variable, confusing, not all evidence-based and often not easy to understand. This review proposes a discharge instruction form containing the six best evidence-based variables (according to the current literature) as being useful and understandable to patients and their families for home observation after MTBI.
  Brain Injury 09/2006; 20(9):889-94. · 1.36 Impact Factor