Sequencing and Integration of Cervical Manual Therapy and Vestibulo-oculomotor Therapy for Concussion Symptoms: Retrospective Analysis.
Christopher Kevin Wong, Lauren Ziaks, Samantha Vargas and 2 others
PMID 33604130WHAT IT FOUND
In 38 patients, a sequenced clinic program combining cervical manual therapy, exercise, canalith repositioning, vision therapy, vestibular rehab and light cardio was associated with improved symptoms.
No control group means the program cannot be shown to have caused the improvement.
Key findings
01General post-concussion symptoms improved significantly at re-evaluation.
02Cervical range of motion returned to normal for 15 of 27 people who had limitations at evaluation.
03Benign paroxysmal positional vertigo symptoms were fully resolved for 28 of 28 diagnosed patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
No control group or comparison treatment was included, so natural recovery and the combined effects of cervical manual therapy, exercise, canalith repositioning, vision therapy, vestibular rehab and light cardio cannot be separated. Only 38 of 59 reviewed records had follow-up data, and the paper says outcomes were unknown for at least 35.6%. The small sample prevented subgroup or regression analysis. Cervical range of motion was analyzed only as normal or limited, and the measurement method and definition of full range of motion were not reported for some patients. Headache was not assessed separately; it was included only within the total Post-Concussion Symptom Scale score. The study used one clinic, so selection bias is possible, and specific manual techniques and return-to-sport outcomes were not recorded.
Declared interests
The authors declared no conflicts of interest, and the study received no funding.
The easy way to misread this
Do not conclude that cervical manual therapy or the three-week sequencing caused recovery. The study had no control group, patients received cervical manual therapy, exercise, canalith repositioning, vision therapy, vestibular rehab and light cardio together, and many concussion symptoms can resolve without treatment.