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Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion.

Abstract

Clinical Scenario: Every year, millions of people suffer a concussion. A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. Clinicians are beginning to incorporate vestibular rehabilitation therapy (VRT) in their postconcussion treatment plan, in order to address the dysfunctional inner ear structures that could be causing this dizziness. Focused Clinical Question: Can VRT help postconcussion syndrome patients experiencing prolonged dizziness by improving their perceived disability? Summary of Key Findings: Three studies were included: 1 randomized control trial, 1 retrospective chart review, and 1 exploratory study. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores. Clinical Bottom Line: There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. VRT is a relatively safe treatment option, with no adverse reactions or case reports. Strength of Recommendation: There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion.

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  • Publisher Full Text
  • Authors

    ,

    Source

    Journal of sport rehabilitation : 2019 Feb 14 pg 1-5

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30040008

    Citation

    Nagib, Steven, and Shelley W. Linens. "Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion." Journal of Sport Rehabilitation, 2019, pp. 1-5.
    Nagib S, Linens SW. Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion. J Sport Rehabil. 2019.
    Nagib, S., & Linens, S. W. (2019). Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion. Journal of Sport Rehabilitation, pp. 1-5. doi:10.1123/jsr.2018-0021.
    Nagib S, Linens SW. Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion. J Sport Rehabil. 2019 Feb 14;1-5. PubMed PMID: 30040008.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion. AU - Nagib,Steven, AU - Linens,Shelley W, Y1 - 2019/02/14/ PY - 2018/7/25/pubmed PY - 2018/7/25/medline PY - 2018/7/25/entrez KW - brain concussion KW - recovery KW - sport medicine KW - survey SP - 1 EP - 5 JF - Journal of sport rehabilitation JO - J Sport Rehabil N2 - Clinical Scenario: Every year, millions of people suffer a concussion. A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. Clinicians are beginning to incorporate vestibular rehabilitation therapy (VRT) in their postconcussion treatment plan, in order to address the dysfunctional inner ear structures that could be causing this dizziness. Focused Clinical Question: Can VRT help postconcussion syndrome patients experiencing prolonged dizziness by improving their perceived disability? Summary of Key Findings: Three studies were included: 1 randomized control trial, 1 retrospective chart review, and 1 exploratory study. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores. Clinical Bottom Line: There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. VRT is a relatively safe treatment option, with no adverse reactions or case reports. Strength of Recommendation: There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion. SN - 1543-3072 UR - https://www.unboundmedicine.com/medline/citation/30040008/Vestibular_Rehabilitation_Therapy_Improves_Perceived_Disability_Associated_With_Dizziness_Postconcussion L2 - http://journals.humankinetics.com/doi/full/10.1123/jsr.2018-0021?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -