Can the neck contribute to persistent symptoms post concussion? Long-term follow up from a prospective descriptive case series

ABSTRACT

Objective: To describe individual long-term outcomes of people with persistent symptoms following a concussion who received neck treatment as part of multidisciplinary concussion care. A secondary objective is to report on how participants describe the outcomes of neck treatmentMethods: Long-term follow-up for a subgroup of participants in a prospective case series (n = 11). Data were collected at initial assessment, completion of neck treatment, 6 and 12 months including standard questionnaires (Rivermead post-concussion symptoms questionnaire, neck disability index, dizziness handicap inventory); patient-reported measures of headache, dizziness and neck pain and participant descriptions of the effects of neck treatmentResults: Grouped measures of post-concussion symptoms were further improved or sustained at 6 and 12 months. Ten of the 11 participants reported neck treatment as a beneficial part of their care and described the effects on the neck, multiple symptoms and their overall recovery. However, seven participants experienced recurrent headache, neck pain or dizziness at 6- or 12-month follow-up.Conclusion: Long-term follow-up of individuals receiving neck treatment shows improvement across a range of patient reported outcomes, yet highlights frequent recurrence of symptoms. Neck treatment can play a valuable role in people’s recovery that extends beyond local effects on the neck.

KEYWORDS:

• Brain concussion
• cervical spine
• physiotherapy

Ethical approval

This case series received ethical approval from the University of Otago Human Ethics Committee (H16/089) and Accident Compensation Corporation Ethics Committee (#314).

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by a Postdoctoral Fellowship in Orthopaedic Manual Therapy at the School of Physiotherapy, University of Otago, New Zealand and held by Dr Ewan Kennedy. This Postdoctoral position was enabled by a generous bequest from the Alumni of the University of Otago in America, Inc. The authors affirm that they have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

Notes on contributors

Ewan Kennedy

This case series was registered with the Australian New Zealand Clinical Trials Register, reference ACTRN12616001183471.