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Concussion and Vestibular Therapy


  • Concussion Therapy

  • Vestibular Therapy

  • Resources

  • Concussion Therapy

    Concussion Therapy

    Children and adolescents are at an increased risk of sustaining a concussion and it can happen from a direct blow to the head during sports, fall from playground equipment, violent events, or a whiplash injury during accidents. The Centers for Disease Control and Prevention reports that one of the age groups with the highest incidence of concussion is children between 0-4 years of age, and individuals aged 15-24 years.

     The pediatric population are more vulnerable for delayed recovery, and are at an increased risk for chronic health problems including anxiety, depression, migraine headaches and impaired school performance if not treated properly. Referral to skilled services is warranted for individuals experiencing delayed recovery and/or individuals planning on returning to sports.

    Concussion can affect multiple body system and can result in chemical changes to the brain and may cause brain cell damage, requiring ongoing multidisciplinary care during the recovery process.

    A diagnosis of concussion is made based on:

    • A history of trauma
    • Onset of signs and symptoms of concussion soon after the injury which represents an acute change from baseline
    • Standardized assessments of symptoms and neurologic examination including balance assessment and neurocognitive function
    • Exclusion of structural intracranial injures by clinical findings and clinical course, with or without neuroimaging

     

    An individual with concussion may experience the following symptoms:

     When to seek Physical Therapy?

    If post-concussion symptoms last beyond anticipated recovery time, a referral to skilled rehabilitation service is warranted. Symptoms lasting >21 days indicates protracted recovery. The recovery time for the general pediatric population is longer than adults where most recovery occurs within <7 days for 80% individuals without any intervention.

    A Physical Therapist can help you if the following symptoms persists:

    • Headache
    • Dizziness
    • Sensitivity to light or sound
    • Balance issues
    • Visual motor issues
    • Feelings of fatigue or having no energy 

     

    What does the Physical Therapist do?

    Evaluation: A pediatric vestibular trained Physical Therapist will perform a thorough initial evaluation to determine presence of cervical, neurological, musculoskeletal, visual-vestibular disorder and evaluate symptoms resulting from concussion. The therapist will also assist in appropriate referrals to other disciplines such as OT, Speech, or Neuropsychology if deemed necessary.

    Treatment: An individualized treatment plan will be created based on evaluation findings for post-concussion symptom management, visual- vestibular rehabilitation, endurance training, balance training as well as management of any persistent musculoskeletal impairments. The therapist will administer standardized assessments, perform exertional testing, and utilize evidenced based practice to monitor progress and help you through optimal recovery as well as guide you through return to sports.

    How to set up an appointment?

    1. Obtain MD prescription for PT evaluation for concussion when symptoms don’t resolve on its own
    2. Call or email Kitestrings to request an initial evaluation appointment or to inquire about whether your child is an appropriate candidate.
  • Vestibular Therapy

    Vestibular Therapy

     

    The vestibular organ is located in out inner ear. Its primary function is to:

    • Tell us where we are in space relative to gravity
    • Helps us keep an image in our eyes stable when our head and body is moving
    • Helps us balance

    The vestibular system works in conjunction with vision and somatosensory system to help us balance. It helps us orient ourselves to space, make postural adjustments, and it determines the speed and direction of movement.

    When the vestibular system is disrupted either due to an injury or disease, the information sent to our brain may be inappropriate. This results in abnormal interpretation of motion causing abnormal sensations and symptoms.

     

     When to seek vestibular evaluation and therapy?

    • If your child falls a lot and has difficulty with balance more so than peers of similar age
    • If your child has nausea, vomiting, migraine, motion sensitivity
    • If you suspect delay in acquisition of motor skills
    • If your child complains of difficulty reading
    • If your child complains of visual disturbances with head and body movement especially double vision and/or blurry vision
    • If your child has poor body awareness, lack of environmental awareness, or seems clumsy

     

    Diagnoses often associated with Vestibular dysfunction in childhood:

    • Sensorineural hearing loss or cochlear implants
    • Chemotherapy- resulting in ototoxicity/vestibulotoxicity
    • Concussion/head trauma
    • Chronic Otitis Media
    • Brain tumor
    • Panic/Anxiety Disorders
    • Unilateral or bilateral vestibular hypofunction
    • Perilymphatic Fistula

     

    Vestibular rehabilitation:

    PT evaluation: A pediatric vestibular trained Physical Therapist will perform a thorough initial evaluation to determine cause and extent of vestibular dysfunction.  The therapist will assess ocular motor function, semicircular canal function, gaze stability, gross motor skills, balance, and overall physical function.

    Treatment: An individualized treatment plan will be created based on evaluation findings. Treatment will include activities that promote postural stability, motor development, as well as symptom management. Your therapist will introduce you to exercises that promote

    • Gaze stability: your ability to keep an image steady when your head and body is moving
    • Habituation: desensitizing your body to symptoms of dizziness
    • Balance training: standing static and dynamic balance with emphasis on challenges and changes with complexity of task

     

    How to set up an appointment?

    1. Obtain MD prescription for PT evaluation for vestibular rehabilitation after your medical doctors rule out more serious and life-threatening conditions first
    2. Call or email Kitestrings to request an initial evaluation appointment or to inquire about whether your child is an appropriate candidate.
  • Resources