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Concussion

Role of Vestibular Rehab in Concussion Management

As sports medicine physicians, we are tasked with the role of evaluating risk factors and symptoms that may delay a patient’s recovery from a concussion.

A
Andrew Schleihauf
Sports Medicine Physician · March 8, 2020 · 3 min read

Overview

As sports medicine physicians, we are tasked with the role of evaluating risk factors and symptoms that may delay a patient’s recovery from a concussion. Researchers have identified that vestibular deficits are commonly seen in the post concussive period. Patients typically complain of dizziness and vertigo.

Symptoms

The forces experienced in the brain during a concussion can directly affect the vestibular system. There are two units that make up the vestibular system. These are the vestibule-ocular system and vestibule-spinal system.

Causes and Risk Factors

The peripheral component of the vestibular system includes the semicircular canals, otoliths, vestibular ganglia and nerve. The central components of the vestibular system include the cerebellum, thalamus, cerebral cortex, and vestibular nuclei. Studies suggest that the peripheral system is more affected in concussions than the central components.

Treatment Options

There are high rates of vestibular dysfunction in concussed athletes. What they found was that 81% of their patients were found to have either a positive vestibulo-ocular reflex or abnormal tandem gait compared to only 0.5% of a general pediatric population. Many studies have looked to see if vestibular rehab serves a role in rehabilitating the concussed athlete.

Recovery

In 2014 published in the British Journal of Sports Medicine, physicians in Calgary looked to see if PT that included vestibular rehab and cervical spine exercises would reduce the time to return to play. What they found was that after 8 weeks, the intervention group had a higher proportion of participants being cleared to return to play. Demonstration of the head impulse test (courtey of link.springer.com) Identifying vestibular dysfunction in concussions can be challenging.

When to See a Doctor

If you are experiencing symptoms that may be related to role of vestibular rehab in concussion management, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.

*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*

Concussion
A
Andrew Schleihauf
Sports Medicine Physician
Sports Medicine Review contributor

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