Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
Laura Levy, DHSc, PA-C
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.
Inserra, Anna, "Does Early Physical Therapy and Vestibular Rehabilitation after a Sports-related Concussion Decrease the Amount of Time for Symptom Resolution When Compared to the Standard of Care?" (2019). PCOM Physician Assistant Studies Student Scholarship. 476.