Physical Therapy Intervention for Extended Physical Symptoms After a Sports-related Concussion
Condition: Concussion; Dizziness
MeSH terms: Dizziness
Study type: Interventional

Summary: 
      The purpose of this study is to investigate if skilled physical therapy treatment for
      dizziness after sports-related concussion, delivered after greater than 30 days
      post-concussion is effective to remediate physical symptoms. This will be the first study
      that explores differential PT treatment for dizziness in concussed athletes who have physical
      symptoms 30+ days after concussion. The findings of this important research have great
      potential to influence clinical practice and place increased emphasis on and acceptance of
      manual skills and neuromotor training in the treatment of concussed patients with dizziness.
    

Detailed description: 
      Patients will be recruited from the ongoing Randomized Clinical Trial (Walsh University HSR
      14-20) that are not returned to play and/or are not asymptomatic at the completion of their
      involvement in this research protocol. Based on the timeframe for their participation in the
      aforementioned study, these athletes will be 30 - 50 days post-concussion. At their final
      visit for the RCT, patients with one of the following criteria will be invited to participate
      in this research study:

        1. Lack of release for Return to Play

        2. Continuation of physical symptoms (headache, nausea, vomiting, balance problems,
           dizziness, light or noise sensitivity, numbness and/or vision problems) as recorded on
           the Post-Concussion Symptom Scale.

      Desired sample size: 15 participants.

      Skilled treatment: patients will be scheduled for a physical therapy assessment. The PTs will
      use a prescriptive approach to the assessment of the central nervous system, the cervical
      spine, and the vestibular system to determine the relative involvement of each system and
      dysfunction contributing to the patient's physical complaints. This assessment will include
      the outcome measures that will be obtained pre and post-treatment (Vertigo Symptom Scale
      (VSS) and the Functional Gait Assessment (FGA). Once the assessment is completed, the PT will
      initiate treatment, with follow-up visits for PT treatment 1 - 2 times per week. They will
      pragmatically design an individualized and progressive treatment plan, including manual
      therapy (manipulation and/or mobilization), neuromotor control strategies, and vestibular
      rehabilitation techniques, depending on the findings at assessment and patient response.
      Therapists can also tailor education regarding mental and physical rest according to specific
      parameters provided by the treating physician. Patients may also be prescribed a home
      exercise program and exercise education. The precise treatment strategies will be recorded.
      At each PT visit, symptomatic recovery will be tracked using the PCS.
    

Intervention name(s): Skilled Therapy
Intervention type(s): Other
Intervention description(s): Active physical therapy treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: physical therapy intervention