Brain Concussion, Mild Traumatic Brain Injury
Conditions
Keywords
Mechanical Diagnosis and Therapy, Directional Preference, Repeated Movements
Brief summary
The purpose of this study is to examine the role of a Mechanical Diagnosis and Therapy (MDT) examination in identifying participants diagnosed with concussion who display a directional preference compared to who don't display a directional preference.
Detailed description
Directional preference describes the clinical phenomenon where a specific direction of repeated movement and / or sustained position results in a clinically relevant improvement in symptoms. This improvement is usually accompanied by an improvement in function or mechanics or both. Its presence and relevance is determined over 2-3 visits. This study aims to identify the proportion of participants with concussion who present with a directional preference during the course of physical therapy. A secondary aim of this study is to investigate whether directional preference is associated with the eventual patient related outcomes following care.
Interventions
BEHAVIORALPhysical Therapy
As part of their normal care, participants will receive any combination of the following interventions to address their specific needs identified during the initial evaluation: cervical spine repeated movements (active range of motion), cervical spine stabilization exercise, aerobic exercise, motor control training, oculomotor/vestibular rehabilitation, stretching, soft-tissue mobilization, joint mobilization, and postural re-education activities.
Sponsors
State University of New York at Buffalo
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
13 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age = 13 - 65 * Complaints of neck pain, headache, or dizziness associated with a diagnosis of concussion or mild TBI * Ability to read/write English * Referral from physician
Exclusion criteria
* Age less than 13 or greater than 65 * Cause of symptoms is result of a work-related accident or motor vehicle accident * Receiving concurrent treatment from a chiropractor or massage therapist * Glasgow Coma Scale less than 12 * Lesion on head CT/MRI * Focal neurological deficits associated with serious spinal pathology (fracture, infection, tumor, vertebrobasilar insufficiency) * Inability to or unwilling to exercise as part of usual PT care * Unable to read/write English * History of osteopenia/osteoporosis or cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Directional preference classification | Through study completion, up to 1 year. | Outcome represents the patient's directional preference at the time of discharge from care. Patients will be classified as directional preference responders or non-responders. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-Concussion Symptom Scale | Through study completion, up to 1 year. | The PCSS is a patient self-reported outcome measure that measures the amount of interference associated with a concussion across four domains: physical, cognitive, emotion, and sleep. The measure consists of 22 questions that relate to post-concussive symptoms. The measure uses a 7-point Likert scale, where 0 = no symptoms and 6 = severe symptoms. The greatest possible score is 132 and the lowest score is 0. Higher scores indicate higher severity of post-concussive symptoms. |
| Neck Disability Index | Through study completion, up to 1 year. | The NDI is a patient self-reported outcome measure that measures the amounts of pain interference and self-reported disability related to neck pain. The measure consists of ten questions in the following domains: pain intensity, personal care, lifting, reading, sleeping, work, recreation, reading, concentration, and headaches. Each item is rated on a 0 to 5 scale, where 0 = no disability and 5 = complete disability. The highest possible raw score equals 50 points, the lowest possible score equals 0. The raw scores can also be converted to a percentage from 0 to 100%. Higher scores indicate higher levels of self-reported disability. |
| Dizziness Handicap Inventory | Through study completion, up to 1 year. | The DHI is a patient self-reported outcome measure that measures the impact of dizziness on daily life. The DHI consists of 25 items measuring the impact of dizziness across three domains: functional (9 questions,= 36 points), emotional (9 questions = 36 points), and physical (7 questions = 28 points). Each item is rated on a 3 point scale (yes = 4, sometimes = 2, no = 0). Item scores are summed, with a possible total of 100 points. The best possible score is a 0. Higher scores indicate greater perceived handicap due to dizziness. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORMichael R Brown, DPT, PhD
University at Buffalo
Outcome results
None listed