Detailed Search Results
| Author/Association: | Schneider KJ, Meeuwisse WH, Nettel-Aguirre A, Barlow K, Boyd L, Kang J, Emery CA |
| Title: | Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial [with consumer summary] |
| Source: | British Journal of Sports Medicine 2014 Sep;48(17):1294-1298 |
| Method: | clinical trial |
| Method Score: | 8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | WHAT ARE THE NEW FINDINGS: Individuals with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion were more likely to be medically cleared to return to sport within 8 weeks of initiation of treatment when they were treated with multimodal physiotherapy. A combination of vestibular rehabilitation and cervical spine physiotherapy may facilitate recovery in individuals with persistent dizziness, neck pain and/or headaches following a sport-related concussion. HOW MIGHT IT IMPACT ON CLINICAL PRACTICE IN THE NEAR FUTURE: Cervical spine physiotherapy and vestibular rehabilitation may be considered as treatment options for individuals with persistent symptoms of dizziness, neck pain and/or headaches following sport-related concussion. Future research to evaluate the optimal timing of treatment and the effects of covariates such as age, history of concussion and dosage is warranted. |
| Abstract: | BACKGROUND/AIM: Concussion is a common injury in sport. Most individuals recover in 7 to 10 days but some have persistent symptoms. The objective of this study was to determine if a combination of vestibular rehabilitation and cervical spine physiotherapy decreased the time until medical clearance in individuals with prolonged postconcussion symptoms. METHODS: This study was a randomised controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12 to 30 years, 18 male and 13 female) were randomised to the control or intervention group. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport, which was evaluated by a study sport medicine physician who was blinded to the treatment group. RESULTS: In the treatment group, 73% (11/15) of the participants were medically cleared within 8 weeks of initiation of treatment, compared with 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI 1.34 to 11.34) times more likely to be medically cleared by 8 weeks. CONCLUSIONS: A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion. TRIAL REGISTRATION NUMBER: NCT01860755. Reproduced with permission from the BMJ Publishing Group. Full text (sometimes free) may be available at these link(s):  help |
