Vestibular Treatment in Adolescents Following Sport Related Concussion
Кључне речи
Апстрактан
Опис
To determine using a RCT design the effectiveness of standard of care behavioral management (i.e., sleep, walking, nutrition, stress management) to standard of care behavioral management (i.e., sleep, walking, nutrition, stress management) (STANDARD OF CARE) plus vestibular exercises (i.e., balance, eye-head movements, and dynamic walking exercises) (VESTIBULAR) for reducing recovery time, symptoms, and vestibular (balance, eye-head movements) and cognitive (e.g., memory, processing speed) impairment in adolescent patients with vestibular clinical profiles following sport--related concussion (SRC).
Датуми
| Последња верификација: | 02/29/2020 |
| Фирст Субмиттед: | 05/10/2018 |
| Предвиђена пријава послата: | 05/30/2018 |
| Прво објављено: | 06/12/2018 |
| Послато последње ажурирање: | 03/02/2020 |
| Последње ажурирање објављено: | 03/03/2020 |
| Стварни датум почетка студије: | 10/17/2018 |
| Процењени датум примарног завршетка: | 03/01/2020 |
| Предвиђени датум завршетка студије: | 03/01/2020 |
Стање или болест
Интервенција / лечење
Behavioral: Vestibular Exercise Intervention Group
Behavioral: Standard of Care Group
Фаза
Групе руку
| Арм | Интервенција / лечење |
|---|---|
| Experimental: Standard of Care Group Standard of Care:
The standard of care protocol consists of standardized in office and at home behavioral management to include sleep, hydration, nutrition, and stress management interventions. Participants will also be assigned physical activity that they will complete during their visits and at home. Physical activity for the standard of care group will include 15 minutes of flexibility/range of motion exercises, and 10 minutes of aerobic-based daily physical activity (e.g.,walking, stationary cycle). | Behavioral: Standard of Care Group The standard of care consists of standardized in office/at home behavioral management including sleep, hydration, nutrition, and stress management interventions. |
| Experimental: Vestibular Exercise Intervention Group The vestibular group will complete the behavioral management activities described above, as well as prescribed in-office and at home vestibular exercises from each of four groups: 1) gaze stability training (i.e., integrated eye and head movements on fixed target), 2) visual motion training (i.e., integrated eye and head movements with busy visual background), 3) standing balance (i.e., standing in different stances), and 4) dynamic gait (i.e., walking with head turns). Participants will be prescribed to one of four levels of these four exercise groups based on presentation of symptoms/impairment as indicated on the VOMS. Progression through the four levels will be based on symptom tolerance and successful completion of all exercises at the current level. | Behavioral: Vestibular Exercise Intervention Group The vestibular exercise intervention group will complete behavioral management activities, and prescribed in--office/at home vestibular exercises from four groups: 1) gaze stability training (integrated eye and head movements on fixed target), 2) visual motion training (integrated eye and head movements on moving target), 3) standing balance (standing with eyes closed in different stances), and 4) dynamic gait (walking with head turns and eye movements). Participants will be prescribed to one of four levels of these exercise groups based on presentation of symptoms/impairment as indicated on VOMS. Progression through the levels will be based on symptom tolerance and successful completion of all exercises at the current level. |
Критеријуми
| Узраст подобан за студирање | 12 Years До 12 Years |
| Полови подобни за студирање | All |
| Прихвата здраве волонтере | да |
| Критеријуми | Inclusion Criteria: - Must be 12-18 years of age. - Must be diagnosed with a sport-related concussion within the last 3-10 days. - Must be identified by UPMC Sports Medicine clinicians as having clinical presentation of a vestibular profile of concussion. - Must report an increase of +2 of symptom provocation on VOMS (from baseline symptom report) on either VOR or VMS measurements during VOMS assessment. Exclusion Criteria: - More than 3 concussions including presenting injury; - Current history or pre-existing vestibular disorder; - Current orthopaedic injury; - History of brain surgery or TBI (based on Glasgow Coma Scale of <13); - History of substance abuse; - History of neurological disorder (seizure disorder, epilepsy, brain tumors or malformations); - Current concussion is non-sport related. The above exclusion factors are known to influence recovery and thus if any one exclusion criterion is met, the athlete will be unable to participate in the current study. |
Исход
Примарне мере исхода
1. Change in VOMS Scores (Vestibular Ocular Motor Screening) from Baseline to 4 Week/Visit 2 [Measures will be conducted at enrollment (within 10 days of injury) and at 2 weeks (+ or - 5 days) and 4 weeks (+ or - 5 days) following treatment.]
