Ewan Kennedy1, Dusty Quinn2, Steve Tumilty3, Cathy M Chapple3. 1. School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand. Electronic address: ewan.kennedy@otago.ac.nz. 2. Back in Motion Ltd, 27-29 Albany Street, Dunedin, 9016, New Zealand. 3. School of Physiotherapy, 325 Great King Street, University of Otago, Dunedin, 9054, New Zealand.
Abstract
BACKGROUND: 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. OBJECTIVES: 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. DESIGN: Retrospective chart review of a consecutive series of patients with concussion referred to a physiotherapist for cervical spine assessment. METHOD: 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. RESULTS/ FINDINGS: 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). CONCLUSIONS: 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.
BACKGROUND: 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. OBJECTIVES: 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. DESIGN: Retrospective chart review of a consecutive series of patients with concussion referred to a physiotherapist for cervical spine assessment. METHOD: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. RESULTS/ FINDINGS: 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). CONCLUSIONS: 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: Takashi Nagai; Nathan D Schilaty; David A Krause; Eric M Crowley; Timothy E Hewett Journal: J Athl Train Date: 2020-01-22 Impact factor: 2.860
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