Vestibular Rehabilitation Effectiveness for Adults With Mild Traumatic Brain Injury/Concussion: A Mini-Systematic Review

Am J Audiol. 2022 Mar 3;31(1):228-242. doi: 10.1044/2021_AJA-21-00165. Epub 2022 Jan 25.

Abstract

Objective: Millions of people suffer from traumatic brain injuries every year with common sequelae, including dizziness, disequilibrium, compromised vision, and gait abnormalities. Individuals suffering a mild traumatic brain injury (mTBI) or concussion may be prescribed bed rest, but for some, symptoms may persist and require different treatment options. The aim of this mini-systematic review was to synthesize the best available evidence regarding the effectiveness of vestibular rehabilitation therapy (VRT) as a treatment option for adults with mTBIs.

Method: A systematic review of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search term concepts were VRT and mTBI. Records meeting the inclusion criteria were extracted from the following databases: PubMed and CINAHL. A manual search of reference lists identified additional studies. Inclusion criteria were (a) participants with mTBI/concussion characterized by dizziness, balance, and/or other vestibular symptoms; (b) VRT as the primary treatment; and (c) self-reported and/or performance-based outcome measures. Data were extracted using a standardized tool, and studies were critically appraised.

Results: Five studies were included in the systematic review: one randomized controlled trial, two retrospective chart reviews, one pre-/post-intervention study, and one case series. Four of the five studies found VRT to be effective at reducing postconcussion symptoms after head injury. Self-reported measures were included in all studies; performance-based measures were included in four out of five studies. None of the studies reported adverse effects of intervention.

Conclusions: Results suggest VRT is an effective treatment option for patients with persistent/lingering symptoms after concussion/mTBI, as demonstrated by self-reported and performance-based outcome measures. Results of this study emphasize the need for audiologists to be thoroughly familiar with VRT as an effective treatment for patients with persistent symptoms following mTBI.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Brain Concussion* / complications
  • Brain Concussion* / diagnosis
  • Brain Concussion* / rehabilitation
  • Dizziness / etiology
  • Humans
  • Post-Concussion Syndrome* / complications
  • Post-Concussion Syndrome* / rehabilitation
  • Retrospective Studies
  • Vertigo / complications