Patients in the control group only received cervical spine therapy Each group underwent weekly treatment sessions for up to 8 wk. Patients in the intervention group received customized VRT and cervical spine therapy. Patients were also separated into 2 groups (☑8 y) to determine if age was a confounding factor All patients suffered concussions by blunt trauma to the head. If VRT was deemed appropriate, they were referred to proper clinicians and included in this studyġ14 patients (ages 8–73 y 67 children, 47 adults), who were referred for VRT following SRC 30 patients did not receive treatment after initial visit for reasons including: VRT not indicated (n = 6), distance to clinic (n = 8), and noncompliance (n = 16)ġ4 patients (ages 18–72 y 6 males, 8 females), who met the World Health Organization’s criteria for PCS. Further research is needed using a standardized VRT protocol.ģ1 patients (ages 12–30 y 18 males, 13 females) Patients presented to clinic after suffering an SRC and experiencing dizziness, neck pain, and/or headache for 10+ d.This data indicate that time since concussion is an independent factor of improved perceived disablility. The exploratory study reported improvements at the 3- and 6-month marks. The chart review included a median time between most recent concussion and referral for treatment as 61 days, however, did not mention a timeline for resolution of symptoms. The randomized control trial had weekly treatment sessions up to 8-weeks postconcussion.All 3 studies included used Dizziness Handicap Index (DHI) as one outcome measure.All 3 studies support the use of VRT to treat postconcussion dizziness.Three studies were included: 1 randomized control trial, 1 exploratory study, and 1 retrospective chart review.The literature search aimed to find original research exploring any type of VRT implemented after suffering a concussion caused by sport or a direct blow to the head.Summary of Search, “Best” Evidence’ Appraised, and Key Findings Strength of Recommendation: There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion. VRT is a relatively safe treatment option, with no adverse reactions or case reports. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. Clinical Bottom Line: There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. 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. 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. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. ![]() A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. Clinical Scenario: Every year, millions of people suffer a concussion.
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