Effects of Vestibular Rehabilitation and Routine Physical Therapy in Athletes With Post Concussion Syndrome

Effects of Vestibular Rehabilitation in Comparison With Routine Physical Therapy on Stability, Kinesiophobia and Return to Sports in Athletes With Post Concussion Syndrome

This randomized controlled trial with a parallel design was conducted over six months at Ghurki Trust Teaching Hospital to compare the effects of Vestibular Rehabilitation and Routine Physical Therapy on stability, kinesiophobia, and return to sports in athletes with post-concussion syndrome. A total of 34 participants aged 12 to 30 years were enrolled based on specific diagnostic criteria. Non probability convenient sampling was used, followed by random allocation into experimental and control groups through computer generated sequencing and sealed envelope concealment. Single blinding was done, with participants unaware of their assigned intervention.

The experimental group received a Vestibular Rehabilitation program consisting of balance training, habituation exercises, and gaze stabilization, while the control group underwent Routine Physical Therapy involving ankle strategies and elliptical training. Both interventions were administered for 30 minutes, three times per week, over four weeks. Outcomes were measured pre- and post-intervention using validated tools: the Balance Error Scoring System (BESS) for postural stability, the Urdu version of the Tampa Scale of Kinesiophobia (TSK), and the Injury Psychological Readiness to Return to Sport Scale (I-PRRS). Data analysis was performed using SPSS version 26, employing appropriate parametric or non-parametric tests based on normality, with significance set at p < 0.05. Ethical approval was obtained, informed consent was secured, and all procedures adhered to established ethical standards.

Inclusion Criteria:

1. Age 12 to 30 years
2. Fulfil the criteria of post concussion syndrome as highlighted by Tator et al.(2016)which requires presence of at least 3 or more persistent symptoms from standardized list
3. Sustained a mTBI in past 3 to 12 weeks
4. Having ongoing symptoms from list in PCSS that started 72 hrs or less after an impact
5. Exhibit objective deficits on standardized baseline examination enabling vestibular and ocular dysfunction

Exclusion Criteria:

• Have a chronic infectious disease.

  • Uncontrolled hypertension.
  • Other neurological disorders (not attributed to their primary diagnosis).
  • Cancer treatment (other than basal cell carcinoma), craniotomy, or refractory subdural hematoma.
  • Those on long term use of psychoactive drugs that compromise their ability to perform study activities
  • Those with pacemakers or elevated cardiovascular risk.
  • Ongoing litigation surrounding their injury.
  • Have been diagnosed with a severe brain injury prior to enrollment, or their post concussive symptoms have persisted beyond 12