Sport-related Concussion
Conditions
Keywords
Sport-related concussion, Dizziness, Neck pain, Headaches, Physiotherapy, Treatment
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.
Interventions
OTHERControl postural education, general range of motion and strengthening in addition to the standard of care
Control: 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.
OTHERPhysiotherapy
Physiotherapy: 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.
Sponsors
Alberta Centre for Child, Family & Community Research
University of Calgary
University of British Columbia
Sport Injury Prevention Research Centre
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
12 Years to 30 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Days to medical clearance to return to sport | up to 8 weeks | Number of days to medical clearance by study physician |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Numeric Dizziness rating Score | Change 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-Headache | Change 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 Score | Change between Baseline and 8 weeks or time of medical clearance | Self report measure of confidence during 16 balance activities |
| Change in Dizziness Handicap Index Score | Change 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 Numeric Pain Rating Scale Score-Neck Pain | Change between Baseline and 8 weeks or time of medical clearance | Self-reported cervical spine pain rated on a scale of 0-10 |
| Head Thrust Test | Baseline 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 Score | Change 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 Score | Change 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 Endurance | Change 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 Error | Change 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. |
| Change in Dynamic Visual Acuity | Change 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. |
Countries
Canada
Outcome results
None listed