Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial

J Manipulative Physiol Ther. 2024 Jan-Jun;47(1-4):1-11. doi: 10.1016/j.jmpt.2024.08.003. Epub 2024 Nov 4.

Abstract

Objective: This study aimed to establish if chiropractic care can improve oculomotor and cognitive symptoms in individuals with persistent postconcussion syndrome (PPCS).

Methods: A single-blind, randomized controlled intervention study recorded baseline computerized eye-tracker assessment (CEA) outcomes in 40 young adults with PPCS following mild traumatic brain injury. Participants were randomly allocated to either a chiropractic or age-matched active control intervention, and the change in CEA outcomes following intervention was compared between the chiropractic and control groups. A battery of CEAs including egocentric localization, fixation stability, pursuit, saccades, Stroop, and the vestibulo-ocular reflex, were used to assess oculomotor function, visual attention/processing, and selective attention.

Results: Relative to the control group, participants receiving the chiropractic intervention scored better in the Stroop test (P < .001), had improved gaze stability during both vestibulo-ocular reflex (P < .001) and fixation stability (P = .009), and a lower vertical error in egocentric localization (P < .001). However, performance was poorer in pursuits, where they had an increased tracking error (P < .001).

Conclusion: Chiropractic care in participants with PPCS significantly improved static and dynamic gaze stability, and performance in the Stroop test, compared with a control intervention. These results suggest that chiropractic care can offer a novel avenue for alleviating certain visual and cognitive symptoms in patients with PPCS. It also adds to the growing evidence that suggests that some longstanding PPCS visual symptoms may have a spinal or proprioceptive basis.

Keywords: Brain Concussion; Chiropractic; Eye-Tracking Technology; Postconcussion Syndrome; Proprioception.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Attention* / physiology
  • Brain Concussion* / complications
  • Brain Concussion* / physiopathology
  • Brain Concussion* / therapy
  • Eye Movements / physiology
  • Female
  • Humans
  • Male
  • Manipulation, Chiropractic* / methods
  • Post-Concussion Syndrome / physiopathology
  • Post-Concussion Syndrome / therapy
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult