Background: Concussion is a common injury in sport. Most individuals recover in 7-10 days but some have persistent symptoms.
Objective: The objective of this study was to determine if a combination of vestibular rehabilitation and orthopaedic physiotherapy decreased the time until medical clearance in individuals with prolonged post-concussion symptoms.
Methods: This study was a randomized controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12-30 years) were randomized to control or intervention group. Both groups received weekly sessions with a physiotherapist for eight weeks or until time of medical clearance. Both groups received postural education, range of motion exercises, cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport which was the evaluated by the study sport medicine physician who was blinded to treatment group.
Results: In the treatment group 73% (11/15) of the participants were medically cleared within eight weeks of initiation of treatment, compared to 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI; 1.34, 11.34) times more likely to be medically cleared by 8 weeks.
Conclusion: A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.