Decreased Medical Clearance Time with Cervicovestibular Rehabilitation After Sports-Related Concussion: Trial

Many Common Symptoms Between Concussion and Neck/Vestibular Injuries

In sports, a concussion is a common injury from which individuals usually recover in 7-10 days. But for athletes whose symptoms persist beyond that point, it is not always clear whether a neck injury is involved and whether the vestibular (balance) system has been affected. Many of the same symptoms are common to concussions and to injuries to the neck and/or balance system known as cervical/vestibular injuries. These include dizziness, unsteadiness, neck pain and/or headaches following a sport-related concussion.

Trial Studies Whether Combined Vestibular Rehab and Cervical Spine Physio Decreases Post-Concussion Recovery Time

In the June 2014 randomized controlled trial "Cervicovestibular Rehabilitation in Sport-Related Concussion", the objective was to determine if a combination of vestibular rehabilitation and cervical spine physiotherapy would decrease the time until individuals with prolonged post-concussion symptoms received medical clearance.

The trial concluded that the combination of cervical and vestibular physiotherapy did significantly decrease the time that youth and young adults who had sustained a sport-related concussion and suffered from persistent symptoms of dizziness, neck pain and/or headaches, were medically cleared to return to their sport. Evidence suggests that a combined approach to treatment of the cervical spine and vestibular systems may facilitate recovery and decrease time lost from sport in individuals with persistent symptoms. Future research is expected to evaluate the optimal timing of treatment and the effects of covariates such as age, history of concussion and dosage.

The trial was conducted by Drs. Kathryn J. Schneider, Willem J. Meeuwise, Alberto Nettel-Aguirre, Karen Barlow, Lara Boyd, Jian Kang and Carolyn A. Emery at the University of Calgary.

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Vestibular Treatment for Concussion Management

Combined Vestibular & Cervical Spine Physiotherapies for Concussion Management Produces Positive Results

When concussion management includes treatment of the vestibular system combined with treatment of the cervical spine, athletes are four times more likely to return to their sport within eight weeks, according to a study conducted by Dr. Kathryn Schneider, a researcher with the Sport Injury Prevention Research Centre at University of Calgary's Faculty of Kinesiology.

Dr. Schneider was both a Vestibular Physiotherapist and an Orthopedic Manual Physiotherapist at LifeMark Health for many years in Calgary before accepting the position of Assistant Professor/Clinician Scientist in Concussion, Faculty of Kinesiology, at the University of Calgary. She has long felt that her concussion patients responded well to treatment of their necks and of their often overlooked vestibular system, so it was exciting to see the research confirm this so convincingly.

High Success Proves Effectiveness of Vestibular Rehabilitation & Cervical Spine Physiotherapy

A Globe and Mail article describing this innovative concussion treatment describes the study. "Thirty-one people between the ages of 12 and 30 (18 males and 13 females), all of them having suffered a sports-related concussion, took part in the study and were split into two groups. Some patients were given a postural education on how to it and stand along with range-of-motion exercises and gradual exertion in their efforts to return to their sport as soon as possible. Others received vestibular rehabilitation plus cervical spine physiotherapy.

The results were utterly one-sided. Of the 15 patients who had the combination vestibular and neck therapy, 11 were medically cleared before or by eight weeks, a 73 per cent success rate. For patients who didn't receive the therapy, only four per cent were considered healthy enough to play again.

Dr. Schneider spent more than a year studying and documenting people who suffered from prolonged post-concussion symptoms such a dizziness, neck pain and headaches. For treatment of cervical spine symptoms involving patients' vertebrae, soft tissues, mobility, strength and posture in the neck, orthopedic Physiotherapy techniques were used. For treatment of vestibular/inner ear dizzines and/or balance issues, she used a variety of different techniques. Some of these included stationary and moving balance work on different surfaces, exercises to coordinate neck muscles and eyes, maintaining focus during head motion, catching a ball while walking, and when indicated, a series of head movements to correct the position of crystals in the inner ear that can sometimes get dislodged with trauma (a condition called BPPV).

At LifeMark Health, we have benefitted from ongoing education provided by Dr. Schneider over many years. Most of our Vestibular Physiotherapists are also Orthopedic Physiotherapists and know how to combine these two types of care in helping our concussion clients recover as quickly as possible.

Contact us to find a vestibular therapist near you.