title: Physical Rehabilitation Interventions for Post-mTBI Symptoms Lasting Greater Than 2 Weeks: Systematic Review.
abstract: BACKGROUND
  Heightened awareness of the lasting effects of mild traumatic brain injury (mTBI) has amplified interest in interventions that facilitate recovery from persistent post-mTBI symptoms.
  
  
  OBJECTIVE
  The purpose of this study was to systematically review the literature to identify potential physical rehabilitation interventions that are safe, feasible, and appropriate for physical therapists to utilize with patients with persistent mTBI-related symptoms.
  
  
  METHODS
  The electronic databases PubMed, Cochrane Library, CINAHL, Scopus, SPORTDiscus, and Web of Science were systematically searched from database inception until June 2015.
  
  
  METHODS
  Studies were included if they utilized physical rehabilitation interventions and the study's participants had a diagnosis of mTBI, a mean age of 8 years or older, and symptoms persisting an average of 2 weeks or longer. Exclusion criteria included blast injuries, diagnosis of moderate or severe TBI, or psychosis.
  
  
  METHODS
  Data extraction and methodological risk of bias assessments were performed for each study.
  
  
  RESULTS
  Eight studies with a range of study designs, intervention types, and outcome measures were included. The interventions investigated by the included studies were categorized into 3 types: physiological, vestibulo-ocular, and cervicogenic.
  
  
  CONCLUSIONS
  The identified studies had several significant limitations including: small sample sizes and low-level study designs.
  
  
  CONCLUSIONS
  The results of this systematic review indicate that several physical rehabilitation options with minimal risk for negative outcomes are available for treating patients experiencing persistent post-mTBI symptoms. These options include: vestibular, manual, and progressive exercise interventions. Conclusions surrounding efficacy and ideal dosing parameters for these interventions are limited at this time due to the small number of studies, the range of interventional protocols, and lower levels of study design.
authors.affiliation: C. Quatman-Yates, PT, DPT, PhD, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229 (USA), and Division of Sports Medicine, Cincinnati Children's Hospital Medical Center. Catherine.quatman@cchmc.org.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quatman-Yates
authors.affiliation: A. Cupp, PT, DPT, Doctor of Physical Therapy Program, University of Toledo, Toledo, Ohio.
authors.forename: Amanda
authors.initials: A
authors.lastname: Cupp
authors.affiliation: C. Gunsch, PT, DPT, Doctor of Physical Therapy Program, University of Toledo.
authors.forename: Cherryanne
authors.initials: C
authors.lastname: Gunsch
authors.affiliation: T. Haley, PT, DPT, Doctor of Physical Therapy Program, University of Toledo.
authors.forename: Tonya
authors.initials: T
authors.lastname: Haley
authors.affiliation: S. Vaculik, PT, DPT, Doctor of Physical Therapy Program, University of Toledo.
authors.forename: Steve
authors.initials: S
authors.lastname: Vaculik
authors.affiliation: D. Kujawa, PT, MBA, Doctor of Physical Therapy Program, University of Toledo.
authors.forename: David
authors.initials: D
authors.lastname: Kujawa
mesh_terms: D001924:Brain Concussion / Q000534:rehabilitation*; D006801:Humans; D026741:Physical Therapy Modalities