Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial

Br J Sports Med. 2014 Sep;48(17):1294-8. doi: 10.1136/bjsports-2013-093267. Epub 2014 May 22.


Background/aim: Concussion is a common injury in sport. Most individuals recover in 7-10 days but some have persistent symptoms. The objective of this study was to determine if a combination of vestibular rehabilitation and cervical spine physiotherapy decreased the time until medical clearance in individuals with prolonged postconcussion symptoms.

Methods: This study was a randomised controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12-30 years, 18 male and 13 female) were randomised to the control or intervention group. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport, which was evaluated by a study sport medicine physician who was blinded to the treatment group.

Results: In the treatment group, 73% (11/15) of the participants were medically cleared within 8 weeks of initiation of treatment, compared with 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI 1.34 to 11.34) times more likely to be medically cleared by 8 weeks.

Conclusions: A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.

Trial registration number: NCT01860755.

Keywords: Concussion; Physiotherapy; Sporting injuries; Sports physiotherapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / rehabilitation
  • Brain Concussion / rehabilitation*
  • Cervical Vertebrae
  • Child
  • Dizziness / rehabilitation
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Neck Pain / rehabilitation
  • Physical Therapy Modalities
  • Recovery of Function
  • Treatment Outcome
  • Vestibular Diseases / rehabilitation
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01860755