A Randomized Controlled Trial of Precision Vestibular Rehabilitation in Adolescents following Concussion: Preliminary Findings
To compare the effectiveness of a 4-week precision vestibular rehabilitation intervention compared with a behavioral management control intervention for adolescents with vestibular symptoms/impairment within 21 days of a concussion. This study used double-blind, randomized controlled trial design in...
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| Veröffentlicht in: | The Journal of pediatrics 2021-12, Vol.239, p.193-199 |
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| creator | Kontos, Anthony P. Eagle, Shawn R. Mucha, Anne Kochick, Victoria Reichard, Jessica Moldolvan, Claire Holland, Cyndi L. Blaney, Nicholas A. Collins, Michael W. |
| description | To compare the effectiveness of a 4-week precision vestibular rehabilitation intervention compared with a behavioral management control intervention for adolescents with vestibular symptoms/impairment within 21 days of a concussion.
This study used double-blind, randomized controlled trial design involving adolescent (12-18 years) patients with a diagnosed sport/recreation-related concussion with vestibular symptoms/impairment from a concussion-specialty clinic between October 2018 and February 2020. Eligible participants were randomized in a 1:1 to either a 4-week vestibular intervention group (VESTIB) or a behavioral management control group (CONTROL). CONTROLS (n = 25) were prescribed behavioral management strategies (eg, physical activity, sleep, hydration, nutrition, stress management) and instructed to perform stretching/physical activity (eg, walking, stationary cycle) 30 minutes/day. VESTIB (n = 25) were prescribed precision vestibular rehabilitation exercises and instructed to perform at-home exercises for 30 minutes/day. Primary outcomes were improvement in Vestibular/Ocular Motor Screening vestibular items (ie, horizontal/vertical vestibular-ocular reflex, visual motion sensitivity) at 4 weeks postenrollment.
We screened 310 and enrolled a total of 55 (18%) adolescent patients who were randomized to one of the interventions. Fifty of fifty-five (91%) participants completed all aspects of the study protocol. Participants in VESTIB improved significantly across the intervention period in horizontal (mean difference-1.628; 95% CI [-3.20, −0.06]; P = .04) and vertical (mean difference-2.24; 95% CI [-4.01, −0.48]; P = .01) vestibular-ocular reflex, but not visual motion sensitivity (mean difference-2.03; 95% CI [-4.26, 0.19]) of the Vestibular/Ocular Motor Screening score compared with CONTROLS.
Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.
ClinicalTrials.gov: NCT03555370. |
| doi_str_mv | 10.1016/j.jpeds.2021.08.032 |
| format | Article |
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This study used double-blind, randomized controlled trial design involving adolescent (12-18 years) patients with a diagnosed sport/recreation-related concussion with vestibular symptoms/impairment from a concussion-specialty clinic between October 2018 and February 2020. Eligible participants were randomized in a 1:1 to either a 4-week vestibular intervention group (VESTIB) or a behavioral management control group (CONTROL). CONTROLS (n = 25) were prescribed behavioral management strategies (eg, physical activity, sleep, hydration, nutrition, stress management) and instructed to perform stretching/physical activity (eg, walking, stationary cycle) 30 minutes/day. VESTIB (n = 25) were prescribed precision vestibular rehabilitation exercises and instructed to perform at-home exercises for 30 minutes/day. Primary outcomes were improvement in Vestibular/Ocular Motor Screening vestibular items (ie, horizontal/vertical vestibular-ocular reflex, visual motion sensitivity) at 4 weeks postenrollment.
We screened 310 and enrolled a total of 55 (18%) adolescent patients who were randomized to one of the interventions. Fifty of fifty-five (91%) participants completed all aspects of the study protocol. Participants in VESTIB improved significantly across the intervention period in horizontal (mean difference-1.628; 95% CI [-3.20, −0.06]; P = .04) and vertical (mean difference-2.24; 95% CI [-4.01, −0.48]; P = .01) vestibular-ocular reflex, but not visual motion sensitivity (mean difference-2.03; 95% CI [-4.26, 0.19]) of the Vestibular/Ocular Motor Screening score compared with CONTROLS.
Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.
ClinicalTrials.gov: NCT03555370.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2021.08.032</identifier><identifier>PMID: 34450120</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Athletic Injuries - complications ; Behavior Therapy - methods ; Brain Concussion - complications ; Child ; Combined Modality Therapy ; Double-Blind Method ; Exercise Therapy - methods ; Female ; Health Behavior ; Humans ; Male ; Treatment Outcome ; Vestibular Diseases - diagnosis ; Vestibular Diseases - etiology ; Vestibular Diseases - rehabilitation</subject><ispartof>The Journal of pediatrics, 2021-12, Vol.239, p.193-199</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-157232701095b5d963a8f07966ffff70afd7d9d899c6deae9f7cff673e05a013</citedby><cites>FETCH-LOGICAL-c359t-157232701095b5d963a8f07966ffff70afd7d9d899c6deae9f7cff673e05a013</cites><orcidid>0000-0002-1580-4971</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2021.08.032$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34450120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kontos, Anthony P.</creatorcontrib><creatorcontrib>Eagle, Shawn R.</creatorcontrib><creatorcontrib>Mucha, Anne</creatorcontrib><creatorcontrib>Kochick, Victoria</creatorcontrib><creatorcontrib>Reichard, Jessica</creatorcontrib><creatorcontrib>Moldolvan, Claire</creatorcontrib><creatorcontrib>Holland, Cyndi L.</creatorcontrib><creatorcontrib>Blaney, Nicholas A.</creatorcontrib><creatorcontrib>Collins, Michael W.</creatorcontrib><title>A Randomized Controlled Trial of Precision Vestibular Rehabilitation in Adolescents following Concussion: Preliminary Findings</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To compare the effectiveness of a 4-week precision vestibular rehabilitation intervention compared with a behavioral management control intervention for adolescents with vestibular symptoms/impairment within 21 days of a concussion.
This study used double-blind, randomized controlled trial design involving adolescent (12-18 years) patients with a diagnosed sport/recreation-related concussion with vestibular symptoms/impairment from a concussion-specialty clinic between October 2018 and February 2020. Eligible participants were randomized in a 1:1 to either a 4-week vestibular intervention group (VESTIB) or a behavioral management control group (CONTROL). CONTROLS (n = 25) were prescribed behavioral management strategies (eg, physical activity, sleep, hydration, nutrition, stress management) and instructed to perform stretching/physical activity (eg, walking, stationary cycle) 30 minutes/day. VESTIB (n = 25) were prescribed precision vestibular rehabilitation exercises and instructed to perform at-home exercises for 30 minutes/day. Primary outcomes were improvement in Vestibular/Ocular Motor Screening vestibular items (ie, horizontal/vertical vestibular-ocular reflex, visual motion sensitivity) at 4 weeks postenrollment.
We screened 310 and enrolled a total of 55 (18%) adolescent patients who were randomized to one of the interventions. Fifty of fifty-five (91%) participants completed all aspects of the study protocol. Participants in VESTIB improved significantly across the intervention period in horizontal (mean difference-1.628; 95% CI [-3.20, −0.06]; P = .04) and vertical (mean difference-2.24; 95% CI [-4.01, −0.48]; P = .01) vestibular-ocular reflex, but not visual motion sensitivity (mean difference-2.03; 95% CI [-4.26, 0.19]) of the Vestibular/Ocular Motor Screening score compared with CONTROLS.
Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.
ClinicalTrials.gov: NCT03555370.</description><subject>Adolescent</subject><subject>Athletic Injuries - complications</subject><subject>Behavior Therapy - methods</subject><subject>Brain Concussion - complications</subject><subject>Child</subject><subject>Combined Modality Therapy</subject><subject>Double-Blind Method</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Health Behavior</subject><subject>Humans</subject><subject>Male</subject><subject>Treatment Outcome</subject><subject>Vestibular Diseases - diagnosis</subject><subject>Vestibular Diseases - etiology</subject><subject>Vestibular Diseases - rehabilitation</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE-LFDEQxYMo7uzqJxCkj166rSTdSUfwMAzuKiwoy-A1ZPJHM6STMele0YOf3bSzejSXCtSrV_V-CL3A0GHA7PWxO56sKR0BgjsYO6DkEdpgELxlI6WP0QaAkJb2nF2gy1KOACB6gKfogvb9AJjABv3aNncqmjT5n9Y0uxTnnEKo3332KjTJNZ-y1b74FJvPtsz-sASVmzv7VR188LOa146PzdakYIu2cS6Nqxbpu49fVkO9lHX6zWoU_OSjyj-aax9N7Zdn6IlTodjnD_UK7a_f7Xfv29uPNx9229tW00HMLR44oYRDDTccBiMYVaMDLhhz9XFQznAjzCiEZsYqKxzXzjFOLQwKML1Cr862p5y-LTWGnHy9NQQVbVqKJANj0EPPxyqlZ6nOqZRsnTxlP9WbJQa5cpdH-Ye7XLlLGGXlXqdePixYDpM1_2b-gq6Ct2eBrSnvvc2yaG-jtsZXvrM0yf93wW8bWZd-</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Kontos, Anthony P.</creator><creator>Eagle, Shawn R.</creator><creator>Mucha, Anne</creator><creator>Kochick, Victoria</creator><creator>Reichard, Jessica</creator><creator>Moldolvan, Claire</creator><creator>Holland, Cyndi L.</creator><creator>Blaney, Nicholas A.</creator><creator>Collins, Michael W.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1580-4971</orcidid></search><sort><creationdate>202112</creationdate><title>A Randomized Controlled Trial of Precision Vestibular Rehabilitation in Adolescents following Concussion: Preliminary Findings</title><author>Kontos, Anthony P. ; Eagle, Shawn R. ; Mucha, Anne ; Kochick, Victoria ; Reichard, Jessica ; Moldolvan, Claire ; Holland, Cyndi L. ; Blaney, Nicholas A. ; Collins, Michael W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-157232701095b5d963a8f07966ffff70afd7d9d899c6deae9f7cff673e05a013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Athletic Injuries - complications</topic><topic>Behavior Therapy - methods</topic><topic>Brain Concussion - complications</topic><topic>Child</topic><topic>Combined Modality Therapy</topic><topic>Double-Blind Method</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Health Behavior</topic><topic>Humans</topic><topic>Male</topic><topic>Treatment Outcome</topic><topic>Vestibular Diseases - diagnosis</topic><topic>Vestibular Diseases - etiology</topic><topic>Vestibular Diseases - rehabilitation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kontos, Anthony P.</creatorcontrib><creatorcontrib>Eagle, Shawn R.</creatorcontrib><creatorcontrib>Mucha, Anne</creatorcontrib><creatorcontrib>Kochick, Victoria</creatorcontrib><creatorcontrib>Reichard, Jessica</creatorcontrib><creatorcontrib>Moldolvan, Claire</creatorcontrib><creatorcontrib>Holland, Cyndi L.</creatorcontrib><creatorcontrib>Blaney, Nicholas A.</creatorcontrib><creatorcontrib>Collins, Michael W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kontos, Anthony P.</au><au>Eagle, Shawn R.</au><au>Mucha, Anne</au><au>Kochick, Victoria</au><au>Reichard, Jessica</au><au>Moldolvan, Claire</au><au>Holland, Cyndi L.</au><au>Blaney, Nicholas A.</au><au>Collins, Michael W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Randomized Controlled Trial of Precision Vestibular Rehabilitation in Adolescents following Concussion: Preliminary Findings</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2021-12</date><risdate>2021</risdate><volume>239</volume><spage>193</spage><epage>199</epage><pages>193-199</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To compare the effectiveness of a 4-week precision vestibular rehabilitation intervention compared with a behavioral management control intervention for adolescents with vestibular symptoms/impairment within 21 days of a concussion.
This study used double-blind, randomized controlled trial design involving adolescent (12-18 years) patients with a diagnosed sport/recreation-related concussion with vestibular symptoms/impairment from a concussion-specialty clinic between October 2018 and February 2020. Eligible participants were randomized in a 1:1 to either a 4-week vestibular intervention group (VESTIB) or a behavioral management control group (CONTROL). CONTROLS (n = 25) were prescribed behavioral management strategies (eg, physical activity, sleep, hydration, nutrition, stress management) and instructed to perform stretching/physical activity (eg, walking, stationary cycle) 30 minutes/day. VESTIB (n = 25) were prescribed precision vestibular rehabilitation exercises and instructed to perform at-home exercises for 30 minutes/day. Primary outcomes were improvement in Vestibular/Ocular Motor Screening vestibular items (ie, horizontal/vertical vestibular-ocular reflex, visual motion sensitivity) at 4 weeks postenrollment.
We screened 310 and enrolled a total of 55 (18%) adolescent patients who were randomized to one of the interventions. Fifty of fifty-five (91%) participants completed all aspects of the study protocol. Participants in VESTIB improved significantly across the intervention period in horizontal (mean difference-1.628; 95% CI [-3.20, −0.06]; P = .04) and vertical (mean difference-2.24; 95% CI [-4.01, −0.48]; P = .01) vestibular-ocular reflex, but not visual motion sensitivity (mean difference-2.03; 95% CI [-4.26, 0.19]) of the Vestibular/Ocular Motor Screening score compared with CONTROLS.
Overall, the vestibular intervention group experienced greater clinical improvements in vestibular symptoms/impairment than controls across the 4-week intervention.
ClinicalTrials.gov: NCT03555370.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34450120</pmid><doi>10.1016/j.jpeds.2021.08.032</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1580-4971</orcidid></addata></record> |
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| ispartof | The Journal of pediatrics, 2021-12, Vol.239, p.193-199 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adolescent Athletic Injuries - complications Behavior Therapy - methods Brain Concussion - complications Child Combined Modality Therapy Double-Blind Method Exercise Therapy - methods Female Health Behavior Humans Male Treatment Outcome Vestibular Diseases - diagnosis Vestibular Diseases - etiology Vestibular Diseases - rehabilitation |
| title | A Randomized Controlled Trial of Precision Vestibular Rehabilitation in Adolescents following Concussion: Preliminary Findings |
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