Vestibular Rehabilitation Therapy Improves Perceived Disability Associated With Dizziness Postconcussion

Clinical Scenario:Every year, millions of people suffer a concussion. A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. Clinicians are beginning to incorporate vestibular rehabilitation therapy (VRT) in their postconcussion treatment plan, in order to address the dysfunctional inner ear structures that could be causing this dizziness.Focused Clinical Question:Can VRT help postconcussion syndrome patients experiencing prolonged dizziness by improving their perceived disability?Summary of Key Findings:Three studies were included: 1 randomized control trial, 1 retrospective chart review, and 1 exploratory study. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores.Clinical Bottom Line:There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. VRT is a relatively safe treatment option, with no adverse reactions or case reports.Strength of Recommendation:There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion.

Download Full-text

Effectiveness of Vestibular Rehabilitation Therapy for Treatment of Concussed Adolescents With Persistent Symptoms of Dizziness and Imbalance

Journal of Sport Rehabilitation ◽

10.1123/jsr.2016-0222 ◽

2018 ◽

Vol 27 (5) ◽

pp. 485-490 ◽

Cited By ~ 10

Author(s):

Kyoungyoun Park ◽

Thomas Ksiazek ◽

Bernadette Olson

Keyword(s):

Vestibular System ◽

Visual Memory ◽

Memory Loss ◽

Vestibular Rehabilitation ◽

Screening Tools ◽

Bottom Line ◽

Rehabilitation Therapy ◽

Early Evaluation ◽

Persistent Symptoms ◽

Sport Concussion

Context:Adolescents who suffer sport concussion typically respond to a prescription of cognitive and physical rest in the acute phases of healing; however, some adolescents do not respond to rest alone. Dizziness, unsteadiness, and imbalance are impairments, which may linger longer than 30 days, leading to a diagnosis of postconcussion syndrome (PCS). Vestibular assessment and therapy may benefit adolescents suffering from these persistent symptoms.Clinical Question:Does vestibular rehabilitation therapy (VRT) rather than continued prescription of rest (cognitive and physical) reduce recovery time and persistent symptoms of dizziness, unsteadiness, and imbalance in adolescents (12–18 y) who suffer PCS following a sports-related concussion?Summary of Key Findings:All 4 studies selected included adolescents suffering from PCS, specifically continued dizziness, unsteadiness, and imbalance. VRT was an effective intervention for this population. Adolescents presenting with this cluster of symptoms may also demonstrate verbal and visual memory loss linked to changes in the vestibular system postconcussion. Improved screening tools can help better understand vestibular system changes, identify adolescents who may benefit from VRT sooner, and decrease long-term impairments.Clinical Bottom Line:Moderate evidence supports that adolescents who suffer from persistent symptoms of dizziness, unsteadiness, and imbalance following sport concussion should be evaluated more specifically and earlier for vestibular dysfunction and can benefit from participation in individualized VRT. Early evaluation and treatment may result in a reduction of time lost from sport as well as a return to their premorbid condition. For these adolescents, VRT may be more beneficial than continued physical and cognitive rest when an adolescent’s symptoms last longer than 30 days.Strength of Recommendation:Grade B evidence exists to support that VRT is more effective than continued cognitive and physical rest in reducing persistent symptoms of dizziness, unsteadiness, and imbalance in adolescents who suffer PCS.

Download Full-text

RANDOMIZED CONTROL TRIAL ON ERANDAMULA GHANAVATI WITH NASYA IN MANYAGRAHA WITH SPECIAL REFERENCE TO CERVICAL SPONDYLOSIS

International Research Journal of Pharmacy ◽

10.7897/2230-8407.1206139 ◽

2021 ◽

Vol 12 (6) ◽

pp. 20-25

Author(s):

Sunil Solanke ◽

Prakash Kabra

Keyword(s):

Cervical Spine ◽

Randomized Control Trial ◽

Cervical Spondylosis ◽

Group Discussion ◽

The Elderly ◽

Control Group ◽

Trial Group ◽

Effect Of Therapy ◽

Randomized Control ◽

And Control

Background: Cervical spondylosis is defined as degenerative changes occurring in the discs and cervical spine. Stating these changes is to be almost universal in the elderly. Cervical Spondylosis correlated with Manyagraha in Ayurvedic perspective. Aim: Aim of the study was to evaluate the effect of Erandamula Ghanavati and Anu Taila Nasya in Manyagraha. Methods: The Group in which Erandamula Ghanavati and Anutaila Nasya were given to patients was termed as Trial Group. The Group in which Panchatikta Ghrita Guggulu and Anutaila Nasya were given to patients was termed as Control Group. During this study 104 patients out of 150 were equally divided into Trial and Control Group by lottery method and comparative study was done. Statistical analysis was done using appropriate tests. Results: Erandamula Ghanavati along with Anu Taila Nasya has reduces symptoms of Manyagraha. Total effect of therapy is more in Trial group as compared to the Control Group. Discussion: As stated by Charak Erandamula is best Vatahara drug. Its Rasa, Virya and Vipak are helpful to alleviate Vata. Erandamula having Snigdha, Madhuraproperties is going to be beneficial in Dhatukshayajanya Vatavyadhi. Conclusion: Erandamula Ghanavati along with Anu Taila Nasya has beneficial for patients of Manyagraha.

Download Full-text

The Effects of the Short Foot Exercise on Navicular Drop: A Critically Appraised Topic

Journal of Sport Rehabilitation ◽

10.1123/jsr.2019-0437 ◽

2021 ◽

Vol 30 (1) ◽

pp. 152-157

Author(s):

Cameron Haun ◽

Cathleen N. Brown ◽

Kimberly Hannigan ◽

Samuel T. Johnson

Keyword(s):

Randomized Control Trial ◽

Control Group ◽

Bottom Line ◽

Navicular Drop ◽

Flexible Flatfoot ◽

Intrinsic Foot Muscles ◽

Group A ◽

Randomized Control ◽

Study Designs

Clinical Scenario: Deformation of the arch, as measured by navicular drop (ND), is linked to lower-extremity musculoskeletal injuries. The short foot exercise (SFE) has been used to strengthen the intrinsic foot muscles that support the arch. Clinical Question: Does the SFE decrease ND in healthy adults? Summary of Key Findings: Three studies that examined the use of the SFE on ND were included. A randomized control trial that compared the SFE to a towel-curl exercise and a control group found no significant differences between the 3 groups. A randomized control trial compared the SFE to the use of arch support insoles in individuals with a flexible flatfoot and found a significant improvement in the SFE group. A prospective cohort study, without a control group, reported a significant decrease in ND following a 4-week SFE intervention without a regression at an 8-week follow-up. Overall, two of the three studies reported a significant reduction in ND following an SFE. Clinical Bottom Line: There is preliminary data supporting the use of the SFE to decrease ND—particularly in individuals with a flexible flatfoot. However, issues with the study designs make it difficult to interpret the data. Strength of Recommendation: Due to limited evidence, there is grade B evidence to support the use of the SFE to decrease ND.

Download Full-text

Cervical Spine Movement During Awake Orotracheal Intubation With Fiberoptic Scope and McGrath Videolaryngoscope in Patients Undergoing Surgery for Cervical Spine Instability: A Randomized Control Trial

Journal of Neurosurgical Anesthesiology ◽

10.1097/ana.0000000000000595 ◽

2019 ◽

Vol 32 (3) ◽

pp. 249-255 ◽

Cited By ~ 1

Author(s):

Kaustuv Dutta ◽

Kamath Sriganesh ◽

Dhritiman Chakrabarti ◽

Nupur Pruthi ◽

Madhusudan Reddy

Keyword(s):

Cervical Spine ◽

Randomized Control Trial ◽

Orotracheal Intubation ◽

Cervical Spine Instability ◽

Randomized Control ◽

Spine Movement

Download Full-text

A Hospice-Based Bereavement Support Group Using Creative Arts

Illness Crisis & Loss ◽

10.1177/1054137315590734 ◽

2015 ◽

Vol 23 (4) ◽

pp. 323-342 ◽

Cited By ~ 6

Author(s):

Breffni McGuinness ◽

Niamh Finucane ◽

Amanda Roberts

Keyword(s):

Support Group ◽

Exploratory Study ◽

Group Intervention ◽

Randomized Control Trial ◽

Qualitative Data ◽

Creative Arts ◽

Bereavement Support ◽

Combined Use ◽

Randomized Control ◽

Bereavement Support Group

There is evidence of the value of individual creative arts (art, drama, music, etc.) in helping people to cope with bereavement. However, there is a gap in the research on the effectiveness of the intentional, combined use of creative arts activities in bereavement support group intervention for adults. This article describes an exploratory study which assessed the effectiveness of using creative arts activities in an eight session support group intervention. A waiting list, randomized control trial supplemented by limited qualitative data was used. Evidence was found that the intervention did help participants’ ability to move between loss and restoration coping when they attended at least six of the eight sessions. However, the use of creative arts activities appears to be more suitable for some people than for others.

Download Full-text