Cognitive Symptoms of Concussion: Planning and Pacing

Cognitive Symptoms of Concussion: Planning and Pacing


Planning and Pacing What you do and how long you do it for can impact the intensity of your symptoms. Planning and pacing is about balancing time you spend on activity and rest time in order to help increase your function and participation in meaningful activities. Over time, you may be less fatigued have fewer headaches finish important tasks and improve your emotional state. The Wellness zone represents when you are symptom free or are experiencing baseline symptoms. The Hazard zone represents when your symptoms are increased. Once in the Hazard Zone symptoms may be exacerbated so much that they will not subside quickly. In other words, you may have over done it. As a result you might be out for the rest of the day and in some cases, even the following day. Now nothing gets done. Ultimately, you want to increase your tolerance for activity without increasing your symptoms or crossing the symptom threshold into the ‘hazard zone’. This might take trial and error. The idea is to gradually increase the amount of activity, complexity of activity and time spent on activity while staying within the Wellness zone. Gradually, your Wellness zone will get larger and reduce the size of the Hazard zone. Start by recognizing or becoming aware of the activities you do and how long you can do them for while staying under the symptom threshold. Try recording your activities in an agenda or log book to monitor your symptoms and successes. Begin with shorter amounts of activity and increase them as tolerated You may have to set time restrictions and use a timer for activities to ensure that a task is stopped before symptoms appear Plan out your days and the tasks you plan on accomplishing in advance And so use a day planner that shows you the entire week. Schedule in the non–negotiable activities the things you must do, first. Make a list of other things you’d like to accomplish and schedule these. You may not be able to do it all at first. Reducing the number of demands for a time is often necessary. When you schedule activities into your week keep in mind your tolerance for that activity and the times of day when you have the most energy. Schedule in breaks and rest into your day. Be pro-active and plan ahead for these. And be sure to schedule enjoyable activities to help maintain a balance. Planning and pacing is a strategy often implemented with the help of a Healthcare professional such as an Occupational Therapist or a Speech-Language Pathologist. It takes time and practice.

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