title: Clinical characteristics and outcomes of treatment of the cervical spine in patients with persistent post-concussion symptoms: A retrospective analysis.
abstract: Concussion is typically defined as a mild brain injury, and yet the brain is unlikely to be the only source of persistent post-concussion symptoms. Concurrent injury to the cervical spine in particular is acknowledged as a potential source of common persistent symptoms such as headache, dizziness and neck pain.
  
  
  
  To describe the cervical spine findings and outcomes of treatment in a series of patients with persistent post-concussion symptoms, and describe the clinical characteristics of a cervicogenic component when it is present.
  
  
  
  Retrospective chart review of a consecutive series of patients with concussion referred to a physiotherapist for cervical spine assessment.
  
  
  
  Patient charts for all patients over a calendar year referred by a concussion service provider to a physiotherapist for cervical spine assessment were de-identified and transferred to the research team. Clinical data were independently extracted by two research assistants and analysed using descriptive statistics.
  
  
  
  Data were analysed from 46 patient charts. Those with a cervicogenic component (n = 32) were distinguished from those without a cervicogenic component (n = 14) by physical examination findings, particularly pain on manual segmental examination. Physiotherapy treatment of the cervicogenic component (n = 21) achieved improvements in function (mean increase of 3.8 in the patient-specific functional scale), and pain (mean decrease of 4.6 in the numeric pain-rating scale).
  
  
  
  The clinical characteristics described give preliminary support to the idea that the cervical spine may contribute to persistent post-concussion symptoms, and highlight the value of physiotherapy assessment and treatment of the cervical spine following a concussive injury.
authors.affiliation: School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand. Electronic address: ewan.kennedy@otago.ac.nz.
authors.forename: Ewan
authors.initials: E
authors.lastname: Kennedy
authors.affiliation: Back in Motion Ltd, 27-29 Albany Street, Dunedin, 9016, New Zealand.
authors.forename: Dusty
authors.initials: D
authors.lastname: Quinn
authors.affiliation: School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand.
authors.forename: Steve
authors.initials: S
authors.lastname: Tumilty
authors.affiliation: School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand.
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Chapple
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D038223:Post-Concussion Syndrome / Q000503:physiopathology* / Q000628:therapy*; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Brain concussion; Cervicogenic; Neck; Physiotherapy