Date Presented 03/22/24
We assessed post-concussive symptoms in young adults using multimodal assessments and found more vestibular symptoms than cognitive and physical. Occupational therapists must intervene in vestibular-ocular deficits to prevent subsequent injuries.
Primary Author and Speaker: Ghazala T. Saleem
Contributing Authors: Xinghong Li, Hoi Yan Leung, Chloe McCann, Corinne McCoy, Rachel Ertrachter, Nolan Przybyciel
PURPOSE: Mild Traumatic brain injury (mTBI) is a leading cause of mortality, whereas 30-80% of reported incidences still show post-concussive symptoms and are unaware of it1,2. This study investigated the differences in functional outcomes between young adults experiencing post-acute concussive symptoms and those without concussions within the past 2 years.
METHOD: A cross-sectional study compared 22 young adults ages 17-21 in two groups [without concussion (n=12) and with concussion (n=10) ranging from 3 to 20 months post-injury]. The primary outcome measures included: Berg Balance Scale, the revised Physical and Neurological Examination of Subtle Signs, Vestibular Ocular Motor Screening (VOMS), Montreal Cognitive Assessment, and Motor-Free Visual Perception Test-4. The study was conducted at an academically affiliated lab at the University at Buffalo.
RESULTS: VOMS showed significant differences (p=.015) between groups. All other measures were nonsignificant. Self-reported vestibular symptoms were also significant (p=.031) post-concussive injury compared to self-reported cognitive and physical symptoms.
DISCUSSSION: Despite medical guidelines of an acute concussion ‘recovery phase’ of 2-4 weeks in young adults, individuals who sustained a concussion experience lingering symptoms for months post-injury, particularly vestibular symptoms. Occupational therapists must evaluate young adults in the sub-acute phase of concussive injury using sensitive assessments for vestibular symptoms, which may remain unidentified or untreated due to self-reported increased cognitive symptoms. Occupational therapists must also develop interventions for vestibulo-oculomotor impairments in young adults with residual post-concussive symptoms.
References
Fehily, B., & Fitzgerald, M. (2017). Repeated Mild Traumatic Brain Injury: Potential Mechanisms of Damage. Cell transplantation, 26(7), 1131–1155. doi.org/10.1177/0963689717714092
Ng, S. Y., & Lee, A. Y. W. (2019). Traumatic Brain Injuries: Pathophysiology and Potential Therapeutic Targets. Frontiers in cellular neuroscience, 13, 528. doi.org/10.3389/fncel.2019.00528
Finn, C. (2019). Occupational therapists’ perceived confidence in the management of concussion: Implications for occupational therapy education. Occupational Therapy International, 2019.
Hux, K. (2009) Screening for traumatic brain injury. Brain Injury, 23(1), 8-14. doi.org/10.1080/02699050802590353
