title: Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial.
abstract: OBJECTIVE
  Concussion is a common injury in sport. Most individuals recover in 7-10 days but some have persistent symptoms. The objective of this study was to determine if a combination of vestibular rehabilitation and cervical spine physiotherapy decreased the time until medical clearance in individuals with prolonged postconcussion symptoms.
  
  
  METHODS
  This study was a randomised controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12-30 years, 18 male and 13 female) were randomised to the control or intervention group. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport, which was evaluated by a study sport medicine physician who was blinded to the treatment group.
  
  
  RESULTS
  In the treatment group, 73% (11/15) of the participants were medically cleared within 8 weeks of initiation of treatment, compared with 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI 1.34 to 11.34) times more likely to be medically cleared by 8 weeks.
  
  
  CONCLUSIONS
  A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.
  
  
  BACKGROUND
  NCT01860755.
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada Faculty of Medicine, Alberta Children's Hospital Research Institute for Child & Maternal Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Schneider
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Willem H
authors.initials: WH
authors.lastname: Meeuwisse
authors.affiliation: Faculty of Medicine, Alberta Children's Hospital Research Institute for Child & Maternal Health, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alberto
authors.initials: A
authors.lastname: Nettel-Aguirre
authors.affiliation: Faculty of Medicine, Alberta Children's Hospital Research Institute for Child & Maternal Health, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Barlow
authors.affiliation: Department of Physical Therapy and Brain Research Centre, UBC Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Lara
authors.initials: L
authors.lastname: Boyd
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jian
authors.initials: J
authors.lastname: Kang
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada Faculty of Medicine, Alberta Children's Hospital Research Institute for Child & Maternal Health, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000534:rehabilitation; D001924:Brain Concussion / Q000534:rehabilitation*; D002574:Cervical Vertebrae; D002648:Child; D004244:Dizziness / Q000534:rehabilitation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019547:Neck Pain / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000534:rehabilitation; D055815:Young Adult
keywords: Concussion; Physiotherapy; Sporting injuries; Sports physiotherapy