Pathway of care for visual and vestibular rehabilitation after mild traumatic brain injury: a critical review

ABSTRACT

Primary Objective

To review the pathway to care for treatment and management of patients receiving visual and vestibular rehabilitation after mild traumatic brain injury (mTBI).

Methods & Procedures

English scientific peer-reviewed articles from PubMed, CINAHL, Embase, and PsycINFO between 2000 and 2020 were first screened by title and abstract, then those selected underwent full-text review and analysis.

Main Outcomes & Results

The database search yielded 1640 results and after title and abstract review, 75 articles were selected for full-text screening, from which 8 were included in the qualitative synthesis. Current evidence includes a limited number of retrospective cohort studies and case studies.

Conclusions

Many patients with visual and vestibular deficits following mTBI do not receive rehabilitation services until months following their injury as there is no standardized pathway to care for patients for visual and vestibular rehabilitation. Barriers to establishing a standardized pathway are the lack of natural history data for visual and vestibular function following mTBI and the lack of randomized clinical trials establishing the efficacy of rehabilitation in patients following mTBI.

KEYWORDS:

• Mild TBI
• vision rehabilitation
• vestibular rehabilitation
• care management
• review

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

Unrestricted grant from Research to Prevent Blindness (Stanford University Department of Ophthalmology), National Eye Institute (P30-EY026877 (Stanford University Department of Ophthalmology).