by Logan Swisher, PT, DPT

BACKGROUND:
A concussion is a type of traumatic brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to move in the skull, creating chemical changes and sometimes stretching or damaging brain cells. Concussions are a common sports injury and most people recover in 7-10 days, but some continue to have persistent symptoms. Two of the most frequently reported symptoms are headache and dizziness, followed closely by nausea and neck pain. Cervical spine trauma may cause prolonged post-concussion headaches. Upper cervical spine dysfunction can cause cervicogenic headaches while dizziness and balance deficits may be due to dysfunction of the vestibular, proprioceptive or central system.

PARTICIPANTS:
29 participants total
-14 participants in the control group
-15 participants in the treatment group

METHODS:
The participants were randomly allocated to the control group or the treatment group. Participants attended physical therapy once per week for 8 weeks. Both groups performed non-provocative range of motion exercises, stretching and postural education by the same physical therapist. Then the intervention group was instructed by another physical therapist for a combination of cervical spine physical therapy and vestibular rehabilitation. The primary outcome measure was number of days from treatment initiation until medical clearance to return to sport.

RESULTS:
Eleven of the 15 participants in the treatment group were medically cleared to return to sport within 8 weeks of treatment. Only 1 of the 14 participants in the control group was medically cleared to return to sport within 8 weeks of treatment. Individuals in the treatment group were 10.27 times more likely to be medically cleared to return to sport as compared to the control group.

CLINICAL APPLICATION:
Here at PTF we will complete a thorough evaluation to determine the origin of the symptoms each patient is experiencing. We will then create a comprehensive treatment plan based on our findings and each patient’s goals. In patients with post-concussion symptoms, we will work to combine cervical spine treatment with vestibular rehabilitation which may facilitate recover and decrease time lost from sports.

ORIGINAL ARTICLE:
Schneider, K. J., Meeuwisse, W. H., Nettel-Aguirre, A., Barlow, K., Boyd, L., Kang, J., & Emery, C. A. (2014, September). Cervicovestibular rehabilitation in sport-related concussion: a randomized controlled trial. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24855132

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