Vestibular Impacts of a Concussion | Guelph Physiotherapy

Jan 26th, 2022

HPC Physiotherapist

A concussion is a functional, traumatic brain injury which can range from mild to severe. Concussions are a common injury that can occur in sport, motor vehicle accidents, and everyday life. From 2016-2017, over 40 thousand Canadian children from the ages of 5 to 19 years old suffered concussions.  

Concussions can be the cause of headaches, dizziness, balance problems, cognitive difficulties and much more. Concussions can also impact the vestibular system of the body, disrupting its function and negatively impacting vestibular reflexes. Most concussions resolve within a few weeks, but recovery varies among individuals.   

What causes a Concussion?  

Concussions can be caused by a direct hit to the head, face, or neck. Concussions can also be caused indirectly by blows to the body or through whiplash movements.  

Signs and Symptoms of a Concussion:  

The common signs and symptoms of a concussion are:  

  • Loss of consciousness at the time of the incident  

  • Disrupted cognitive function (i.e. slowed reaction time, memory deficit, feeling “foggy” etc.) 

  • Impaired motor function (i.e. limb stiffness/locking of joints)  

  • Headache  

  • Dizziness  

  • Neck pain  

  • Postural and/or balance disturbances (i.e. losing balance, falls, etc.)  

  • Feeling highly irritable/angry  

  • Sleep disturbances (i.e. insomnia, drowsiness, etc.)  

  • Light and/or sound sensitivity  

How is a Concussion Diagnosed?  

Concussions can be diagnosed by physicians or other licensed healthcare providers such as physical therapists at a concussion clinic. There are several assessment tools used by healthcare providers to assess for concussion, so assessments may vary.  

In general, assessment for a concussion involves checking the cervical spine and cranial nerves to ensure they are not involved in the injury. Cognitive function and postural control will also be assessed using a variety of tests. 

Physiotherapy Treatment for the Vestibular Effects of Concussions:  

What is Vestibular Physiotherapy?  

Vestibular physiotherapy is a form of physical rehabilitation targeted to reduce dizziness, balance problems, and headaches, all of which are common after concussion. Vestibular therapies are patient-specific and work to target the symptoms that are causing the most problems for the patient at that time.  

How Does Vestibular Rehabilitation Work?  

Gaze stabilization, also known as adaptation, helps to improve vision clarity as the head moves for activities like reading, taking notes in class, or walking, and driving. Gaze stabilization exercises usually involve rotating the head while fixating the gaze on a visual target.  

Balance training is important for ensuring that patients can perform daily tasks or specific activities like sports as safely as possible. Balance exercises usually involve standing with different foot positions on stable or wobbly surfaces and will be targeted towards your specific balance problem.  

Habituation, or dizziness training, helps to improve dizziness in scenarios specific to the head positions that aggravate patient symptoms like bending down to pick up items. Habituation exercises improve the body’s response to those uncomfortable head positions through repetition.  

What are the Risks and Benefits of Vestibular Rehabilitation?  

There are many long-term benefits of vestibular rehabilitation, making it a suitable treatment for dizziness and balance problems after concussion.  

Studies have shown that patients who have completed vestibular rehabilitation have decreased dizziness and headaches and improved balance compared to those who have not received vestibular treatment following a concussion. 

Vestibular rehabilitation can also help speed up concussion recovery times and prevent long-term symptoms.  

Sometimes vestibular rehabilitation will worsen symptoms during rehabilitation exercise performance and for a short time after. These symptoms can include dizziness, headaches, nausea, and balance difficulties. If you do experience any new symptoms or worsening of symptoms during rehabilitation treatment, you are advised to tell your healthcare provider.  

For more information about concussions, or the Guelph Phsyiotherapists at the Health and Performance Centre’s specialized concussion clinic, reach out to us today. 

 

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*About the HPC Student Volunteer Program* 

Each year, approximately 30 University of Guelph students are selected following a competitive application process to take part in the “HPC Volunteer Program.” This program provides an opportunity for U of G student volunteers to translate their academic knowledge into practice, while gaining first-hand experience and mentorship from the team of certified physiotherapists and chiropractors at the University of Guelph’s Health and Performance Centre. As a result of this exceptional partnership between the University of Guelph and the HPC practitioners, students can gain valuable insight on evidence-based practice prior to graduating from their respective programs. Click here for more information on co-curricular experiential learning opportunities at the University of Guelph. This article was written by members of the 2021-22 HPC Student Volunteer Program. 

References 

Canada, P. H. A. of. (2020, October 21). Government of Canada. Canada.ca.  

https://www.canada.ca/en/public-health/services/diseases/concussion-sign-symptoms/sportrecreation.html.   

Concussion Assessment. Physiopedia. (2021). https://physiopedia.com/Concussion_Assessment?utm_source=physiopedia&utm_medium=related_articles&ut m_campaign=ongoing_internal.   

Farrell, L. (2015). Vestibular Rehabilitation: An Effective, Evidence-Based Treatment. Vestibular Disorders Association.   

McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M., Bailes, J., Broglio, S., Cantu, R. C., Cassidy, D.,  

Echemendia, R. J., Castellani, R. J., Davis, G. A., Ellenbogen, R., Emery, C., Engebretsen, L.,  

Feddermann-Demont, N., Giza, C. C., Guskiewicz, K. M., Herring, S., Iverson, G. L., Johnston, K. M., … Vos, P. E. (2017). Consensus statement on concussion in sport-the 5th international conference on concussion in sport held in Berlin, October 2016. British journal of sports medicine, 51(11),  

838–847. https://doi.org/10.1136/bjsports-2017-097699   

What is Concussion? Physiopedia. (2021). https://physiopedia.com/What_is_Concussion%3F?utm_source=physiopedia&utm_medium=related_articles&u tm_campaign=ongoing_internal.