Concussion and Vestibular Therapy
By: Dr. Joanne Balint, PT, DPT
Dynamics Physical Therapy
A concussion is a mild traumatic brain injury which makes it difficult for the brain to function properly. For some people, the effects of a concussion can linger for weeks to months, and can often include a vestibular dysfunction. People of all ages can be affected, and symptoms can range from being mildly dizzy and headachy to being truly debilitating.
For many people, they are unable to do activities such as turning their heads, walking and looking around, being in a busy environment, or even attending work or school. Concussion rehabilitation can help improve persistent symptoms and get patients back to their lives, including returning to sports. Concussion rehabilitation in physical therapy often involves both vestibular therapy and subthreshold exertional training.
Vestibular dysfunctions involve the inner ear, which is responsible for balance, dizziness, and the sense of where you are in space. They often occur after a concussive head injury, but can occur other times as well. Often they feel dizzy, headachy or queasy. Vestibular therapy is very effective for symptoms and diagnoses such as BPPV (Benign Paroxysmal Positional Vertigo), dizziness, vertigo, imbalance and concussions. Evaluations involve using computer equipment and video frenzel goggles to record and watch eye motions. This equipment can help detect involuntary eye motions as the brain tries to compensate for abnormal feedback from the vestibular system.
Vestibular therapy involves retraining your brain to re-coordinate your vestibular and vision systems. Treatment is very individualized. For some patients, only a few sessions are needed, as others take months, involving more diverse treatments and gradual improvement.
Subthreshold exertional training involves retraining your brain and body to be symptom free at gradually higher heart rates, during progressive activities, and can be very effective at reducing symptoms after a head injury. Exercises are done in the clinic and at home, always within narrow, prescribed guidelines that do not provoke any symptoms. For athletes, there is a progression toward return to sport activities that are tailored to each sport and each patient.
Symptoms that indicate that concussion rehabilitation may be helpful for you include: headache, dizziness, nausea, vertigo, blurred vision, loss of balance, difficulty reading or using electronic devices, difficulty driving, and an increase in symptoms when working out.
If you are experiencing any of these symptoms, an evaluation may be beneficial to you.