PTCohortPhysical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine2024

Cervical spine proprioception and vestibular/oculomotor function: An observational study comparing young adults with and without a concussion history.

Katherine L Smulligan, Patrick Carry, Andrew C Smith and 4 others

PMID 39013262

WHAT IT FOUND

Young adults 6 months to 3 years after concussion had worse dizziness, more neck position errors, and more symptoms during eye and balance tests than controls.

Neck error was not related to dizziness, but symptoms during testing were.

Key findings

01Among 88 adults, those with concussion history had significantly worse cervical spine proprioception, more vestibular/oculomotor symptom provocation, and higher dizziness scores than those without concussion history.

02After adjusting for age, sex, and anxiety/depression history, concussion history remained significantly associated with more head repositioning error, more positive visio-vestibular exam subtests, and higher Dizziness Handicap Inventory scores.

03In the concussion history group, more positive visio-vestibular exam subtests were significantly correlated with worse Dizziness Handicap Inventory scores, but head repositioning error was not correlated with dizziness.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study used a convenience sample recruited through social media, flyers, and word of mouth, so the results may not apply to all people with a concussion history. People who still felt symptoms or had lingering concerns after concussion may have been more likely to volunteer, which could affect the observed differences. Because all assessments happened at one time point, the study cannot show that concussion caused the impairments. Pre-existing differences may have made people more likely to sustain a concussion. The analysis did not account for all possible influences, such as prior cervical spine injury or vestibular conditions like vertigo. The concussion group included both sport-related and non-sport-related concussions, and injury mechanism may affect outcomes. The study did not test whether these impairments predict later injury or whether treating them helps.

The easy way to misread this

Do not conclude that concussion caused these impairments or that checking them improves recovery. This was a cross-sectional observational study, and it did not test treatment.

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