We recently covered the US Department of Veterans Affairs’ (VA) Mobile App Store, which includes apps for both providers and patients. One of the most intriguing apps listed on this store is the Concussion Coach. Designed to help educate users on concussion symptom management and education, in addition to providing support resources, the app is primarily geared towards patients. The app was developed through a multi-disciplinary team including the VA’s Rehabilitation and Prosthetic Services, National Center for Post-Traumatic Stress Disorder, and Department of Defense National Center for Telehealth and Technology.
Of note, the term “concussion” is used throughout the app to refer to all types of brain injury. The app itself is geared towards those who have experienced a mild to moderate traumatic brain injury. The American Congress of Rehabilitation (1995) has defined mild traumatic brain injuries to be the same as a concussion, with specific criteria for such. There are a variety of other brain injury scales available in addition, including the American Academy of Neurology Guidelines, Cantu Guidelines, and Colorado Medical Society Guidelines that provide more specifics on the grading (mild, moderate, and severe) for traumatic brain injuries.
Currently, Concussion Coach is only available for iOS devices (5.0 or later), and is free. At the time of release (2013), a promised Android version was in the works. However, there has been no update since and no release for Android. I have attempted to contact the team behind Concussion Coach for clarification on the lack of an Android version but haven’t heard back. MeriTalk recently reported on concerns about the funding behind some of the VA apps, and it’s unknown if this will will affect Concussion Coach.
Concussion Coach is subdivided into 5 key sections: Learn (concussion 101, symptoms, treatment, types of associated headaches, sleep, cognitive symptoms, anxiety, and irritability), Self-Assessment (symptom tracking), Manage the Moment (selection of coping tools and symptom management options), Build Resilience (Wellness journal, goal recording), and Resources and Support (Both VA and outside resources for patients). In addition, at startup, users can elect to be screened to determine if they may have experienced a concussion in the past.
I found the educational portion of Concussion Coach fairly comprehensive. Much of TBI management in an outpatient rehabilitation setting involves education and symptom management. This primer for patients includes many of the symptoms TBI patients may experience and is a good resource for clinicians to consider pointing their patients for information on the topic. The Manage the Moment tool is perhaps the most intriguing part of the app and the closest Concussion Coach gets to actual treatment of symptoms. Think of it as a host of self-management options, designed to address specific issues patients may encounter. Users simply select the topic that most closely corresponds to what they are currently struggling with at that very moment (headache, irritability, trouble sleeping, etc). Most of these interventions start with users rating their degree of distress, from 0-10, then completing an exercise (Deep Breathing, Thought observation, Muscle relaxation, Grounding, Mindful Walking, etc). These predominately are various forms of mindfulness exercises, and include soothing audio narrations. Several are “Pleasant Activities” and while they may be a great option, they often may not be realistic for patients seeking an intervention right at the moment (Join a Book Club, Go to the Beach, etc).
Concussion Coach relies heavily on both patient education and mindfulness therapy exercises for much of the interventions within the app. We have covered other apps that have shown positive effects in small studies in the past, such as the SuperBetter app for pediatrics. These psychological interventions have a limited higher-level evidence basis (Cochrane has several reviews on the topic with positive or insufficient evidence results), however they are currently recommended to be considered as part of the VA’s Clinical Practice Guidelines for mild traumatic brain injury. There is a degree of customizability in the app, as users can choose images, songs, audio, and specific support contacts to be loaded from their own files into the app. Of course, Concussion Coach is quick to remind users that it is not a replacement for professional treatment. Furthermore, this app is not meant to be used for acute injuries. It’s best situated to be used in conjunction while a user has an active relationship with a health care provider.
Additional Information: Concussion Coach Mobile App
Overall, Concussion Coach is a very impressive app from the VA and DoD. The background education information alone makes it a winner, and the added self-management tools further help round out this app. Clinicians treating patients who have experienced a mild to moderate traumatic brain injury, and are open to the use of an app, may consider adding Concussion Coach to their repertoire of management options. Of course, the iOS nature of the app really limits the audience and it’s concerning that there hasn’t been any update to Concussion Coach for several years. I reached out to the VA’s Mobile App department but couldn’t find out if any further updates were planned. As such, I wouldn’t hold my breath waiting for an Android version at this point, unfortunately. However, Concussion Coach is still a fully-functioning app and worth checking out if you have a device that supports it.
- Overall Score
- User Interface
Easy to navigate and setup, and very easy to utilize the various interventions listed.
- Multimedia Usage
Very simplistic visual design, could use a more appealing facelift.
Currently completely free, through iTunes. Can’t beat that price!
- Real World Applicability
Offers both patient education and evidence-based self-management options. Some of the interventions may be unrealistic, but is easy to skip to another treatment option.
- Available for DownloadiPhoneiPad