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Effects of Physiotherapy in Individuals With Persistent Symptoms Following Concussion

Not Applicable
Completed
Conditions
Sport-related Concussion
Interventions
Other: Control postural education, general range of motion and strengthening in addition to the standard of care
Other: Physiotherapy
Registration Number
NCT01860755
Lead Sponsor
Sport Injury Prevention Research Centre
Brief Summary

The purpose of this study is to determine the effects of a combined physiotherapy treatment (including vestibular rehabilitation and treatment for the cervical spine) in youth and young adults with ongoing symptoms of dizziness, neck pain and headaches following a sport-related concussion.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
31
Inclusion Criteria
  • Diagnosis of Sport-related concussion as per the Third International Consensus Guidelines
  • Persistent symptoms (greater than 10 days) of dizziness, unsteadiness, neck pain and/or headaches reported on the Sport Concussion Assessment Tool 2 (SCAT2)
  • Clinical examination findings suggesting vestibular and/or cervical spine involvement
Exclusion Criteria
  • Fracture, other neurological conditions, musculoskeletal injuries (other than the cervical spine) that restrict activity and medications that affect neural adaptation

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PhysiotherapyControl postural education, general range of motion and strengthening in addition to the standard of carePhysiotherapy: including vestibular rehabilitation and multimodal treatment for the cervical spine, once weekly with the study physiotherapist for 8 weeks or until time of medical clearance to return to sport. This group also received the control intervention.
PhysiotherapyPhysiotherapyPhysiotherapy: including vestibular rehabilitation and multimodal treatment for the cervical spine, once weekly with the study physiotherapist for 8 weeks or until time of medical clearance to return to sport. This group also received the control intervention.
ControlControl postural education, general range of motion and strengthening in addition to the standard of careControl: postural education, general range of motion and strengthening in addition to the standard of care rest followed by graded exertion. Individuals were seen once weekly for eight weeks or until time of medical clearance to return to sport.
Primary Outcome Measures
NameTimeMethod
Days to medical clearance to return to sportup to 8 weeks

Number of days to medical clearance by study physician

Secondary Outcome Measures
NameTimeMethod
Change in Numeric Pain Rating Scale Score-Neck PainChange between Baseline and 8 weeks or time of medical clearance

Self-reported cervical spine pain rated on a scale of 0-10

Change in Numeric Dizziness rating ScoreChange between Baseline and 8 weeks or time of medical clearance

Self reported dizziness on a scale of 0-10

Change in Numeric Pain Rating Scale Score-HeadacheChange between Baseline and 8 weeks or at time of medical clearance

Self-report score for headache on a scale of 0-10

Change in Activities Specific Balance Confidence Scale ScoreChange between Baseline and 8 weeks or time of medical clearance

Self report measure of confidence during 16 balance activities

Change in Dizziness Handicap Index ScoreChange between Baseline and 8 weeks or time of medical clearance

Self report measure evaluating perceived handicap secondary to dizziness

Change in Sport Concussion Assessment Tool 2 (SCAT2)Change between Baseline and 8 weeks or time of medical clearance

Multifaceted tool used in the assessment of concussion and includes domains of symptom report, cognitive function, balance and coordination

Change in Dynamic Visual AcuityChange between Baseline and 8 weeks or time of medical clearance

Assessed clinically using an eye chart and a metronome set at 2 Hz. Static visual acuity is measured 13 feet from the target. The subjects head is rotated at 2 Hz and visual acuity is measured dynamically. The difference between static and dynamic visual acuity is calculated.

Head Thrust TestBaseline and at 8 weeks or time of medical clearance

Clinical test performed in sitting with head flexed and high velocity low amplitude motion into 5-15 degrees rotation is performed while the subject is asked to maintain focus with the examiner's nose.

Change in modified Motion Sensitivity Test ScoreChange between Baseline and 8 weeks or time of medical clearance

Patient report of intensity and duration of dizziness with eight head or body motions

Change in Functional Gait Assessment ScoreChange between Baseline and 8 weeks or time of medical clearance

Dynamic Balance Measure that includes 10 different movements and the ability to complete each activity is rated by the examiner.

Change in Cervical Flexor EnduranceChange between Baseline and 8 weeks or time of medical clearance

Test to evaluate the time (seconds) that an individual can maintain the head in a position of craniovertebral flexion and two finger widths above a pillow in crook lying.

Change in Joint Position ErrorChange between Baseline and 8 weeks or time of medical clearance

Clinical test using a laser pointer affixed to a head piece on top of the head that is projected onto a bull's eye target. Subject rotates head to left, right (rotation) or up (extension) to the maximum comfortable range and relocates to the perceived point of neutral head position with eyes closed. A measures from the centre of the bull's eye is recorded. A mean of three trials is recorded for each direction.

Trial Locations

Locations (1)

Sport Injury Prevention Research Centre

🇨🇦

Calgary, Alberta, Canada

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