Effects of Vestibular Rehabilitation in the Treatment of Dizziness and Balance Disturbances After Concussion
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Concussion
- Sponsor
- Beth Marschner
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Dynamic Gait Index
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
The goal of this clinical trial is to study the effects of including vestibular rehabilitation in the treatment of dizziness and balance disturbances in athletes after concussion. The main questions it aims to answer are:
- Does inclusion of vestibular rehabilitation treatment have an effect on symptom resolution in those with concussion?
- Does inclusion of vestibular rehabilitation treatment have an effect on the rate of recovery and return to play after concussion? Researchers will compare vestibular rehabilitation treatment inclusion in concussion treatment to a traditional concussion treatment approach to see if the rate of symptom resolution and return to play are affected by including vestibular rehabilitation for participants who have experienced a concussion within one week of presenting for the study.
Participants will:
- Be randomly assigned to either receive vestibular rehabilitation included in their concussion treatment or have traditional concussion treatment without vestibular rehabilitation.
- Complete treatment sessions two times per week for up to four weeks
- Complete the corresponding home program for the treatment group
- Complete baseline symptom testing and repeat the symptom testing at study completion for data comparison. Testing includes: Sport Concussion Assessment Tool (SCAT5) including 1) the athlete's background 2) symptom evaluation 3) cognitive screening 4) neurological screening and 5) delayed recall, a Dynamic Gait Index (DGI) including 1) gait on level surface 2) change in gait speed 3) gait with horizontal head turns 4) gait with vertical head turns 5) gait and pivot turn 6) step over obstacle 7) step around obstacle 8) stairs, and a vestibular evaluation including 1) patient history 2) visual assessment 3) vertebral artery clearance 4) cervical spine clearance 5) inner ear assessment 6) brief balance assessment.
Detailed Description
Nothing further to include that is not entered or uploaded elsewhere in the record
Investigators
Beth Marschner
Assistant Professor
Minot State University
Eligibility Criteria
Inclusion Criteria
- •Athlete from a small regional university
- •Experiences a concussion
- •Identified by their certified athletic trainer to have dizziness or balance dysfunctions
- •Referred for initial contact testing and treatment
Exclusion Criteria
- •Acute spinal cord injury with neurological deficits
- •Epidural and subdural hematoma with known manifestations
- •Acute cervical spine injury
Outcomes
Primary Outcomes
Dynamic Gait Index
Time Frame: Up to 4 weeks
The Dynamic Gait Index (DGI) includes 1) gait on level surface 2) change in gait speed 3) gait with horizontal head turns 4) gait with vertical head turns 5) gait and pivot turn 6) step over obstacle 7) step around obstacle 8) stairs. Each item is scored on a four-point ordinal scale, ranging from 0-3. "0" indicates the lowest level of function, severe impairment and "3" indicates the highest level of function, normal. There are a total of 24 possible points. The lower the score out of 24, the more balance difficulties.
Sport Concussion Assessment Tool 5
Time Frame: Up to 4 weeks
The Sport Concussion Assessment Tool 5 includes: athlete's background, symptom evaluation, cognitive screening, neurological screening, and delayed recall. The symptom scale is from 0 (none) to 6 (severe). There are 22 symptoms with a max score of 132. The higher the score, the more severe. The cognitive screening includes 5 orientation questions, immediate memory using recall of 5 word lists, concentration tasks of backward digit recall starting with three digits and progressing to more if able, recalling the months of the year in reverse and delayed recall at the end of the assessment for the immediate memory word list again. The neurological screening assesses reflexes, pupil response and motor function. Balance is examined using the modified balance error scoring system where more errors indicates more balance issues.
Oculomotor Assessment
Time Frame: Up to 4 weeks
Oculomotor Assessment is used to evaluate eye movement and function to determine if movement and function are normal or abnormal. This includes: smooth pursuits, horizontal saccades, vertical saccades, convergence, vestibulo-ocular reflex (VOR), and visual motion sensitivity Test (VMS).
Semicircular Canal Assessment
Time Frame: Up to 4 weeks
Semicircular Canal Assessment is used to evaluate how well the inner ear's semicircular canals detect head movement. Tests included in this were the Hallpike-Dix for assessing the posterior canal and the Roll Test for assessing the horizontal canal.