Brian T. Swanson
© 2015 Elizabeth Mosley
Background: Post-concussion syndrome is defined as a group of symptoms occurring after a traumatic brain injury (TBI) that can persist for durations ranging from weeks to years. The Centers for Disease Control and Prevention estimates that 1.7 million Americans experience TBI annually. Vestibular rehabilitation has been shown to help alleviate common symptoms after concussions, such as dizziness, headaches and impaired balance. The purpose of this case report is to describe the physical therapy management of a patient with post-concussion symptoms two months post-injury. Case Description: The patient is a 17-year-old female with a history of concussion following a syncopal episode two months prior to the initial evaluation. The patient was referred to physical therapy for evaluation and treatment of continued post-concussion symptoms including headaches and dizziness that worsened with activity. The examination indicated impaired static and dynamic balance. An impaired vestibular ocular reflex was indicated by dynamic visual acuity testing and a positive head thrust test. Outcomes: Following five weeks of vestibular rehabilitation, including static and dynamic balance exercises, as well as gaze stabilization, the patient reported improvement in the frequency of dizziness symptoms allowing return to school and work as a waitress. The patient showed significant improvement in all functional testing, including the dizziness handicap inventory, functional gait assessment, balance error scoring system test and the four-square step test. Discussion: The patient’s improvement in dizziness, headaches, static and dynamic balance, and improved vestibular ocular reflex demonstrate the potential benefits of vestibular rehabilitation for a patient suffering from post-concussion symptoms. Further research needs to be conducted comparing individuals with concussions who receive vestibular rehabilitation to those who recover with rest only.
Mosley, Elizabeth, "Vestibular Rehabilitation For A 17-Year Old Female With Post-Concussion Symptoms: A Case Report" (2015). Case Report Papers. 43.