Vestibular Rehab

This is a Current Treatment for the Concussive Episode

Dustin Fink3 Comments

First and foremost there is no “scientific” evidence of actual medical effectiveness with the product, however there has been recent and popular observational data to suggest that this modality and product may help.  The said product is the GyroStim;

The GyroStim™ is a fully automated, computer-controlled multi-axis rotating chair. Its spacious design is comfortable and safe, and can accommodate many types of individuals ranging from small children to elite athletes to those with significant disabilities.

I bet any sports fan out there has seen it, it was highlighted in the recovery of Sidney Crosby and most recently another NHL star Guillaume Latendresse of the Minnesota Wild.  The thought process is that when a concussion occurs one of the systems affected is the vestibular.  For the layman the vestibular system is responsible for our awareness in space using very fine and specific equipment in the inner ear.  Imagine when you were younger and had just gotten out of a pool from swimming and had water in your ears, then you decided to shake your head or run real fast and found yourself “a bit off”.  This is similar in nature with a concussion, the violent forces to the head can create a disruption of this system, Continue reading →

Concussion – After Injury Care

Dustin Fink5 Comments

Most cases of concussion resolve spontaneously over time, we have had discussions on here that vary from 72 hours to 6 months or longer – however, people/researchers are trying to find a way to help along recovery.  Most of this is an inexact science, to say the least, it is almost the ol’ adage of “throw crap on the wall and see if it sticks.”

Lindsay Barton wrote a great summation of current ideas for therapy for lingering effects of concussion, in some cases being classified as PCS, or post concussion syndrome, for Mom’s Team.  I do like his list which includes;

  • Craniosacral therapy
  • Chiropractic Neurology
  • Vestibular Rehabilitation
  • Amantadine
  • “Buffalo Protocol”
  • Epsom Salts

The first three are very “hands on” Continue reading →

Sleeping is Good

Dustin Fink8 Comments

It used to be that doctors would tell you to keep people awake with head injuries.  That has changed, quite a bit.  Keeping someone awake might be indicated for a possible brain bleed, but concussions need the sleep and recovery time.

Sleeping is first. If you’re not sleeping, forget it,” said Cara Camiolo Reddy, the co-director of the UPMC Rehabilitation Institute brain program and the medical adviser to the Sports Medicine concussion program. Sleep is vital in the recovery process because the injured brain needs rest to begin to heal itself. The concussion program and Camiolo prescribe medications, however, only to post-concussion syndrome sufferers who are three weeks or longer into their injury.

This quote was from and article by Chuck Finder of Scrips Howard News Services and appeared on NewsChief.com today.

In the article you will find that this prescription is not widely accepted by the community that deals with concussion management.  However in my experience it is vital to let the brain rest.  When I am debriefing with the athlete and their parents, the most often question I get is “can you sleep too much?”.  My answer is no.  To make the parents feel better I have them arouse the concussed individual at infrequent rates to observe their arousal response.  I also have the parents ask the three words that we asked the person to remember right after the concussion episode.

With our experience at our school, the kids and parents that abided by the recommendations of sleep and complete brain rest have recovered at a much quicker rate.  The kids and parents that did not listen are still dealing with symptoms and have yet to be cleared.

I know that is not a research study in its most proper form, but the observational evidence tells us, and those in the above article that sleep is indeed needed.

Vestibular Rehab For Concussions

Dustin Fink43 Comments

We all know, or should know, that balance issues are a primary concern with concussions and post-concussion syndrome.  Along with memory problems, balance disturbance is high on the predictor list for duration of symptoms ergo severity.

As an athletic trainer one of our primary tests, and “go-to” is the Rhomberg Test, or sobriety test as most may know it as.  What is tested there is the gross balance and fine motor movements controlled by the brain and vestibular system of our ears.  During a concussive episode the synapses (or messages being sent) between the neurons in the brain get disrupted, each individual will experience different durations.  Using the knowledge that balance is commonly and most immediately affected by a concussion the Rhomberg provides great feedback.

During the Rhomberg the athlete is challenged with single leg balance, tandem walking, spatial awareness and other concentration efforts that would otherwise be very simple.  These menial tasks become very difficult when you are concussed.  Now imagine those small but difficult tasks and dizziness plaguing you on a daily basis days, weeks or even months after you have sustained a concussion.

Alsalaheen, Mucha, et al. provided a research study in which they Continue reading →