Citation

Kontos AP, Eagle SR, Mucha A, Kochick V, Doman J, Moldolvan C, Holland CL, Blaney NA, Collins MW. J. Pediatr. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.jpeds.2021.08.032

PMID

unavailable

Abstract

OBJECTIVE: To compare the effectiveness of a 4-week precision vestibular rehabilitation intervention compared with a behavioral management control intervention for adolescents with vestibular symptoms/impairment within 21 days of a concussion. STUDY DESIGN: This study utilized double-blind, randomized controlled trial design involving adolescent (12-18) patients with a diagnosed sport/recreation-related concussion with vestibular symptoms/impairment from a concussion-specialty clinic between October 2018 through February 2020. Eligible participants were randomized in a 1:1 ratio to either a 4-week vestibular intervention group (VESTIB) or a behavioral management group (CONTROL). CONTROLS (N=25) were prescribed behavioral management strategies (eg, physical activity, sleep, hydration, nutrition, stress management) and instructed to perform stretching/physical activity (eg, walking, stationary cycle) 30 minutes/day. VESTIB (N= 25) were prescribed precision vestibular rehabilitation exercises and instructed to perform at-home exercises for 30 minutes/day. Primary outcomes were improvement in Vestibular/Ocular Motor Screening (VOMS) vestibular items (ie, horizontal/vertical vestibular-ocular reflex, visual motion sensitivity) at 4-weeks post-enrollment.

RESULTS: We screened 310 and enrolled a total of 55 (18%) adolescent patients who were randomized to one of the interventions. 50/55 (91%) participants completed all aspects of the study protocol. Participants in VESTIB improved significantly across the intervention period in horizontal (mean difference-1.628; 95% CI: [-3.20, -0.06]; P =.04) and vertical (mean difference-2.24; 95% CI: [-4.01, -0.48]; p=0.01) vestibular-ocular reflex, but not visual motion sensitivity (mean difference-2.03; 95% CI: [-4.26, 0.19]) of the Vestibular/Ocular Motor Screening score compared with CONTROLS.

CONCLUSIONS: Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.

Language: en