Effectiveness of vestibular rehabilitation on concussion-induced vertigo: a systematic review

Abstract

Background: Approximately 5% of all Americans have experienced a concussion sometime during their lifetime. The predominant symptoms associated with a concussion are physical issues, cognitive issues, emotional issues, and sleep disturbances; and one of the most common physical issues is vertigo.

Objectives: The purpose of this systematic review was to investigate the effectiveness of vestibular rehabilitation on concussion-induced vertigo.

Methods: Those databases that were utilized for search terms included CINAHL Complete, Proquest Medical Library, and PubMed. Each of these databases was examined from inception through the end of 2017. The search terms were ‘concussion’ OR ‘brain injury’ OR ‘head injury’ AND ‘vestibular rehabilitation’ OR ‘vestibular therapy’ AND ‘vertigo’ OR ‘dizziness’. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence system was used to assess the evidence level of each included study, and methodological rigor was assessed utilizing criteria set forth in a systematic review by Medlicott and Harris.

Results: Seven articles met the inclusion criteria and were included in the qualitative synthesis. Six of the seven studies had an evidence level of less than two, and four of the seven studies had weak methodological rigor. Despite these limitations, this systematic review demonstrated that vestibular rehabilitation is generally an effective intervention for individuals with concussion-induced vertigo, even in the presence of visual disorders.

Conclusions: Vestibular rehabilitation should be considered as a component of the plan of care for individuals who experience vertigo following a concussion.

Keywords:

• Concussion
• dizziness
• systematic review
• vertigo
• vestibular rehabilitation

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Nicole Marie Cron

Dr. Bonni Lynn Kinne is an associate professor in the department of physical therapy at Grand Valley State University. In addition, she continues to service the needs of patients with vestibular disorders on a part-time basis. She has developed six different vestibular rehabilitation continuing education courses, and she presents these courses several times per year across the country. She is nationally certified in vestibular rehabilitation, and she has published several peer-reviewed journal articles in this area of physical therapy.

Rachel Leigh Iaquaniello

Dr. Jamie Lynn Bott, Dr. Nicole Marie Cron, and Dr. Rachel Leigh Iaquaniello each graduated from Grand Valley State University with a doctoral degree in physical therapy in 2017.