脑研究杂志

Vestibular Rehabilitation: Dizziness and Balance Disorders after a Concussion

Abstract

Giorgio Sandrini

Introduction: The management of dizziness and balance impairment following a concussion is a substantial concern. The goal of this study was to see if vestibular rehabilitation may help persons with concussions feel less dizzy and improve their gait and balance.

Methods: A retrospective chart analysis of 114 patients referred for vestibular therapy following concussion was undertaken (67 children aged 18 years and younger [mean, 16 years; range, 8–18 years]; 47 adults aged 18 years and older [mean, 41 years; range, 19–73 years]. At the time of the initial evaluation and discharge, outcome measures of self-report (e.g., dizziness severity, Activities-specific Balance Confidence Scale, and Dizziness Handicap Inventory) as well as gait and balance performance (e.g., Dynamic Gait Index, gait speed, and the Sensory Organization Scale) were recorded. The effect of vestibular rehabilitation therapy was investigated using a mixed-factor repeated-measures analysis of variance. To see if there was an influence of vestibular rehabilitation therapy and age on the outcome measures, researchers performed a mixed-factor repeated-measures analysis of variance.

Results: The median period between the concussion and the initial evaluation was 61 days. 84 of the 114 patients who were referred came back for more than one appointment. At the time of release, these patients showed improvements in all self-report, gait, and balance performance tests (P.05). Children improved more in dizziness severity (P.005) and the Sensory Organization Test conditions 1 (eyes open, fixed support) and 2 (eyes closed, fixed support) (P.025).

Discussion: After a concussion, vestibular rehabilitation may help to lessen dizziness and improve gait and balance. The improvement was not dependent on age for most criteria, showing that vestibular therapy may benefit both children and adults equally.

Conclusion: Vestibular rehabilitation should be explored in the treatment of those who have dizziness, gait, and balance problems after a concussion that do not improve with rest.