PTCase ReportInternational journal of sports physical therapy2021

The Utility of Neuromotor Retraining to Augment Manual Therapy and Vestibular Rehabilitation in a Patient with Post-Concussion Syndrome: A Case Report.

Andrew Teare-Ketter, Alyssa LaForme Fiss, Jeffrey Ebert

PMID 33604153

WHAT IT FOUND

A 21-year-old male with chronic post-concussion syndrome reported complete resolution of dizziness, neck pain, and balance issues after eight physical therapy sessions.

Headaches remained mild and infrequent. This single case does not prove the treatment works for others.

Key findings

01The subject's symptoms completely resolved except for mild, infrequent headaches at discharge.

02The Rivermead Post-Concussion Questionnaire score dropped from 20 to 2 out of 64.

03Balance testing normalized, with the Fukuda Step Test rotation decreasing from 70 degrees to 20 degrees.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This is a single case report, so the results cannot be generalized to other patients. The treatment included multiple interventions (manual therapy, vestibular rehab, neuromotor retraining, electrical stimulation) simultaneously, making it impossible to determine which component, if any, caused the improvement. The authors note that sensitive objective tests like the VOMS or Dynamic Visual Acuity were not performed. The subject had a history of four previous concussions, which may influence recovery patterns. The primary therapist was a student supervised by a licensed PT.

Declared interests

No specific funding sources or commercial conflicts of interest are mentioned in the text. The study was approved by the Mercer University Institutional Review Board.

The easy way to misread this

Do not assume that this combination of manual therapy, vestibular rehab, and neuromotor retraining will resolve symptoms for other patients with post-concussion syndrome. This is a single case report with multiple concurrent interventions, so it is impossible to know which part of the treatment, if any, led to the improvement.

Read it on PubMed →