Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review
# Background Concussion in children is a significant public health burden in the United States with 2.3 million children under the age of 17 years sustaining a concussion in 2022 alone. Children post-concussion experience a wide range of symptoms of vestibular dysfunction. Vestibular rehabilitation...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2025-02-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.128282 |
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| author | Devashish Tiwari Melisa Erdal Kristyn Alonzo Victoria Twombly Paige Concannon August West Mairead O'Byrne |
| author_facet | Devashish Tiwari Melisa Erdal Kristyn Alonzo Victoria Twombly Paige Concannon August West Mairead O'Byrne |
| author_sort | Devashish Tiwari |
| collection | DOAJ |
| description | # Background
Concussion in children is a significant public health burden in the United States with 2.3 million children under the age of 17 years sustaining a concussion in 2022 alone. Children post-concussion experience a wide range of symptoms of vestibular dysfunction. Vestibular rehabilitation therapy (VRT) has been shown to substantially decrease dizziness and improve gait and balance function in adults post-concussion, but limited information is available for children.
Purpose: The purpose of this systematic review was to determine the effectiveness of VRT on improving vestibular function, postural control, and gait in children post-concussion.
# Study design
Systematic review.
# Methods
An electronic search of MEDLINE and CINAHL was conducted in October 2022 and later updated in April 2024 using MeSH terms and keywords related to vestibular rehabilitation, concussion, and children. Quality appraisal was conducted independently by two reviewers using the Joanna Briggs Institute checklist, the Critical Appraisal Skills Programme checklist and Cochrane risk of bias assessment tool. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were utilized for screening and data extraction.
# Results
Overall, twelve studies (three randomized controlled trials, five cohort studies, two case series and two case reports) were included in the review. The Dizziness Handicap Inventory (DHI) was the most frequently utilized measure (five studies). Three studies reported a statistically significant improvement in DHI (change scores = 19-25, p < 0.05), gait speed (F = 38.3, p < 0.001), Balance Error Scoring System (BESS) (change score percentage 12.1 – 52%, p < 0.01), and Activities-specific Balance Confidence (ABC) scale (change = 20-29 points, p <0.01).
# Conclusion
VRT shows promise and may result in symptom improvements in children post-concussion when used as part of a multimodal intervention plan. Further research with larger samples is recommended to make informed decisions about dosage and long-term functional outcomes in children post-concussion.
# Level of Evidence
3 |
| format | Article |
| id | doaj-art-ae95d4a41a9f4e4b9ab337e3c049999e |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-ae95d4a41a9f4e4b9ab337e3c049999e2025-02-01T02:57:06ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962025-02-01202Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic ReviewDevashish TiwariMelisa ErdalKristyn AlonzoVictoria TwomblyPaige ConcannonAugust WestMairead O'Byrne# Background Concussion in children is a significant public health burden in the United States with 2.3 million children under the age of 17 years sustaining a concussion in 2022 alone. Children post-concussion experience a wide range of symptoms of vestibular dysfunction. Vestibular rehabilitation therapy (VRT) has been shown to substantially decrease dizziness and improve gait and balance function in adults post-concussion, but limited information is available for children. Purpose: The purpose of this systematic review was to determine the effectiveness of VRT on improving vestibular function, postural control, and gait in children post-concussion. # Study design Systematic review. # Methods An electronic search of MEDLINE and CINAHL was conducted in October 2022 and later updated in April 2024 using MeSH terms and keywords related to vestibular rehabilitation, concussion, and children. Quality appraisal was conducted independently by two reviewers using the Joanna Briggs Institute checklist, the Critical Appraisal Skills Programme checklist and Cochrane risk of bias assessment tool. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were utilized for screening and data extraction. # Results Overall, twelve studies (three randomized controlled trials, five cohort studies, two case series and two case reports) were included in the review. The Dizziness Handicap Inventory (DHI) was the most frequently utilized measure (five studies). Three studies reported a statistically significant improvement in DHI (change scores = 19-25, p < 0.05), gait speed (F = 38.3, p < 0.001), Balance Error Scoring System (BESS) (change score percentage 12.1 – 52%, p < 0.01), and Activities-specific Balance Confidence (ABC) scale (change = 20-29 points, p <0.01). # Conclusion VRT shows promise and may result in symptom improvements in children post-concussion when used as part of a multimodal intervention plan. Further research with larger samples is recommended to make informed decisions about dosage and long-term functional outcomes in children post-concussion. # Level of Evidence 3https://doi.org/10.26603/001c.128282 |
| spellingShingle | Devashish Tiwari Melisa Erdal Kristyn Alonzo Victoria Twombly Paige Concannon August West Mairead O'Byrne Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review International Journal of Sports Physical Therapy |
| title | Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review |
| title_full | Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review |
| title_fullStr | Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review |
| title_full_unstemmed | Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review |
| title_short | Effectiveness of Vestibular Rehabilitation in Children Post-Concussion: A Systematic Review |
| title_sort | effectiveness of vestibular rehabilitation in children post concussion a systematic review |
| url | https://doi.org/10.26603/001c.128282 |
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