Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not early physical therapy and vestibular rehabilitation after a sports-related concussion (SRC) decreases the amount of time for symptom resolution compared to the standard of care.

STUDY DESIGN: Systematic review of two randomized controlled trials published in 2014 and 2017, and one case series published in 2010.

DATA SOURCES: All articles, which analyzed the effect of vestibular therapy on treatment of concussive symptoms, were presented in English and were taken from peer-reviewed sources using PubMed and EBSCOhost.

OUTCOMES MEASURED: Days from onset of vestibular rehabilitation for persisting concussive symptoms to medical clearance for return to play (RTP) through the clinical judgement of a sports medicine provider, and subjective resolution of concussive symptoms on symptom severity scales.

RESULTS: The two RCT’s performed by Schneider et. al. and Reneker et. al. yielded a significant reduction in return-to-play time and symptom resolution in patients receiving vestibular rehabilitation when compared to the control (p<0.001). The case series by Alsalaheen et. al. utilized ANOVA to show a positive correlation between vestibular therapy for resolution of post-concussive symptoms (p<0.001).

CONCLUSIONS: Outcomes measured in these three studies demonstrate that earlier physical therapy and vestibular rehabilitation is effective in reducing a teenage or young adult athlete’s time to return-to-play after sustaining a sports-related concussion, when compared to the standard of care, as it aids in symptom resolution. Further studies can be done with larger sample sizes to reinforce the significant outcomes.

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