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    Improving concentration after a concussion



    Story by David White 

    Dwight D. Eisenhower Army Medical Center

    Aparna Vijayan, Ph.D., CCC-SLP
    TBI Clinic
    Eisenhower Army Medical Center

    A common complaint after having sustained a concussion is difficulty with focusing or concentrating when engaged in activities such as listening, reading or working. The Pomodoro technique is a time-management technique to help improve productivity. It can be adapted to improve concentration skills as well.
    The Pomodoro technique proposes the use of a kitchen timer to work on an activity for 25 minutes, take a break for five minutes, and repeat this pattern for a total of four sets, amounting to a total work time for a given task (reading, writing, etc.) of two hours. Each time set of 25 minutes with the five-minute break is called One Pomodoro.
    The technique recommends that after every four Pomodoros; i.e.: two hours, one can take a longer break for 15 minutes, 30 minutes or longer, depending on the nature of the task.
    4 Pomodore technique
    • No. 1: 25-minute work/read—five-minute stretch break
    • No. 2: 25-minute work/ read—five-minute stretch break
    • No. 3: 25-minute work/read—five-minute stretch break
    • No. 4: 25-minute work /read—five-min stretch break
    Total time: two hours
    This method is ideal for anyone who has sustained a concussion and is dealing with any pain (headaches, back pain, etc.), changes in mood (frustration, anxiety, etc.) and sleep disturbances.
    Often these individuals report they cannot focus on a task for more than a few minutes. In lieu of working for 25 minutes, the service member can work for 15-20 minutes depending on their level of pain or fatigue. However, the duration of the break cannot exceed five minutes.
    The five-minute break should be used only for stretching, bathroom breaks, having a snack or drink, and most importantly, keeping track of the progress made. This will help the practitioners of this method manage his time more efficiently and improve productivity.
    The five-minute break cannot be used for listening to music, watching television or engaging in social media.
    This approach can be used for any task – reading a book for pleasure, reading a book or article for work or school, writing a report, working on putting together a book shelf, working on the car. It can be used in the workplace as well.
    An example of a time schedule for the work place is provided below.
    Adapting for the work place
    Get to work.
    • Four Pomodoros (two hours)—10 minute break
    • Four Pomodoros (two hours)—30 minute lunch break
    • Four Pomodoros (two hours)—10 minute break
    • Four Pomodoros (two hours)
    Go home.
    Personal tasks such as returning a phone call can be addressed during the longer 10-minute break. Programming regular stretch breaks will help offset the negative effects of pain, mood, sleep or fatigue on effective performance on the task at hand. The break will also allow the service member to evaluate the progress made and re-adjust their goals for the task.
    The timer application in a smart phone or computer — on-line timer — can be used. There are also commercial timers for people who cannot take their smart phones into their work place. Once the practitioner gets comfortable with time management, they can adjust the time based on the level of difficulty of the task.
    Some of the benefits of this technique are alleviation of anxiety while managing time more efficiently and allowing one to concentrate one’s efforts on the tasks that need to be accomplished.
    The Pomodoro technique has been adapted to meet the service members needs in Eisenhower Army Medical Center’s Traumatic Brain Injury clinic and has yielded successful results for motivated patients.
    Feedback provided has ranged from the service member not feeling tired at home after a long day of work, not getting frustrated when working or reading, and being able to concentrate and remember what she was reading.
    Most recently, one service member reported he had closed his eyes one to two minutes after every 25 minutes when taking a six-hour long, work-related language exam. He passed with the highest scores he had ever achieved.



    Date Taken: 03.07.2022
    Date Posted: 03.08.2022 11:53
    Story ID: 415924
    Location: FORT GORDON, GA, US 

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