@article{ref1,
title="A randomized controlled trial of precision vestibular rehabilitation in adolescents following concussion: preliminary findings",
journal="Journal of pediatrics",
year="2021",
author="Kontos, Anthony P. and Eagle, Shawn R. and Mucha, Anne and Kochick, Victoria and Doman, Jessica and Moldolvan, Claire and Holland, Cyndi L. and Blaney, Nicholas A. and Collins, Michael W.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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. <br><br>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. <br><br>CONCLUSIONS: Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.<p /> <p>Language: en</p>",
language="en",
issn="0022-3476",
doi="10.1016/j.jpeds.2021.08.032",
url="http://dx.doi.org/10.1016/j.jpeds.2021.08.032"
}