Julia E Hurtado1, Lisa Heusel-Gillig2, Benjamin B Risk3, Anna Trofimova4, Syed A Abidi5, Jason W Allen4,6, Russell K Gore1,7. 1. Shepherd Center, Complex Concussion Clinic, Atlanta, GA, USA. 2. Department of Rehabilitation Medicine, Emory Dizziness and Balance Center, Atlanta, GA, USA. 3. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 4. Diagnostic Radiology, Department of Radiology and Imaging Sciences, Neuroradiology Division, Emory University School of Medicine, Atlanta, GA, USA. 5. School of Medicine, Emory University, Atlanta, GA, USA. 6. Department of Neurology, Emory University School of Medicine, Emory University School of Medicine, Atlanta, GA, USA. 7. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Abstract
PURPOSE: Post-concussive visually induced dizziness (VID), in which symptoms are provoked by exposure to complex visual motion, is associated with protracted recovery. Although vestibular rehabilitation therapy (VRT) is recommended to treat post-concussive dizziness, there is sparse literature reporting on specific VRT interventions treating VID. METHODS: A consecutive series of 26 individuals referred for VRT post-concussion were retrospectively assessed for inclusion in this case series. Each participant underwent a combination of conventional VRT and a technology-enhanced visual desensitization home exercise program (HEP). Self-report and objective measures were recorded from initial and discharge therapy evaluations. Twenty-three individuals (mean age 23.1 ± 12.4) with post-concussive dizziness (mean 109 ± 56 days post-injury) and no evidence for peripheral vestibular dysfunction were included. Treatment duration averaged 6.9 ± 2.5 weeks. RESULTS: There were significant improvements in post-intervention on subjective and objective measures of dizziness and gait (p < .05). The response to intervention was independent of pre-injury migraine history but pre-injury depression/anxiety increased self-report of post-treatment anxiety. Concurrent treatment with medications did not influence response to treatment. CONCLUSIONS: The combination therapy intervention improved outcome measures consistent with VRT treatment outcomes in both concussion and non-traumatic vestibular conditions. Individuals referred for VRT post-concussion warrant assessment for VID and may benefit from the addition of technology-enhanced visual desensitization.
PURPOSE: Post-concussive visually induced dizziness (VID), in which symptoms are provoked by exposure to complex visual motion, is associated with protracted recovery. Although vestibular rehabilitation therapy (VRT) is recommended to treat post-concussive dizziness, there is sparse literature reporting on specific VRT interventions treating VID. METHODS: A consecutive series of 26 individuals referred for VRT post-concussion were retrospectively assessed for inclusion in this case series. Each participant underwent a combination of conventional VRT and a technology-enhanced visual desensitization home exercise program (HEP). Self-report and objective measures were recorded from initial and discharge therapy evaluations. Twenty-three individuals (mean age 23.1 ± 12.4) with post-concussive dizziness (mean 109 ± 56 days post-injury) and no evidence for peripheral vestibular dysfunction were included. Treatment duration averaged 6.9 ± 2.5 weeks. RESULTS: There were significant improvements in post-intervention on subjective and objective measures of dizziness and gait (p < .05). The response to intervention was independent of pre-injury migraine history but pre-injury depression/anxiety increased self-report of post-treatment anxiety. Concurrent treatment with medications did not influence response to treatment. CONCLUSIONS: The combination therapy intervention improved outcome measures consistent with VRT treatment outcomes in both concussion and non-traumatic vestibular conditions. Individuals referred for VRT post-concussion warrant assessment for VID and may benefit from the addition of technology-enhanced visual desensitization.
Authors: J W Allen; A Trofimova; V Ahluwalia; J L Smith; S A Abidi; M A K Peters; S Rajananda; J E Hurtado; R K Gore Journal: AJNR Am J Neuroradiol Date: 2021-02-11 Impact factor: 3.825
Authors: Stefano Scarano; Valeria Ada Sansone; Carola Rita Ferrari Aggradi; Elena Carraro; Luigi Tesio; Maurizio Amadei; Viviana Rota; Alice Zanolini; Antonio Caronni Journal: Front Hum Neurosci Date: 2022-07-28 Impact factor: 3.473