Of the approximately 1.3 million (1) people, diagnosed annually with a mild traumatic injury, like concussion, 80% to 90% follow a normal recovery course with full symptom resolution within 3 months of injury.(2,3) The remaining 10% to 20% who are refractory to conventional care may have persistent post-concussion impairments lasting months to years.(4,5) These impairments can include poor performance on divided-attention and dual-tasks activities that combine physical demand (ie, balance and gait) with cognitive loads.(6,7)
Mild traumatic brain injury can compromise reaction time, visual perception, memory, attention, balance, and gait. These deficits, especially if persistent, can restrict participation in daily activities and the resumption of personal and profession roles. (8) Treatments for motor vehicle accident injury concussion, slip and fall concussion or mild traumatic injury concussion consisted of clinical techniques including optokinetic stimulation, vestibular rehabilitation and postural stability exercises, targeting specific impairments. After a month treatment, most patients demonstrated significant increases in postural and gait balance with a near complete resolution of all post-concussion symptoms. They successfully returned to normal daily life. 1. Sosin DM, Sniezek JE, Thurman DJ. Incidence of mild and moderate brain injury in the United States, 1991. Brain Inj. 1996;10(1):47-54. 2. Alexander MP. Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology. 1995;45(7):1253-1260. 3. Binder LM, Rohling ML, Larrabee GJ. A review of mild head trauma. Part I: meta-analytic review of neuropsychological studies. J Clin Exp Neuropsychol. 1997;19(3):421-431. 4. Ruff R. Two decades of advances in understanding of mild traumatic brain injury. J. Head Trauma Rehabil. 2005;20(1):5-18. 5. Ruff RM, Camenzuli L, Mueller J. Miserable minority: emotional risk factors that influence the outcome of a mild traumatic brain injury. Brain Inj. 1996;10(8):551-565. 6. Catena RD, Van Donkelaar P, Chou L-S. Cognitive task effects on gait stability following concussion. Exp Brain Res. 2007;176:23-31. 7. Parker TM, Osternig LR, Van Donkelaar P, Chou L-S. Gait stability following concussion. Med Sci Sports Exerc. 2006;38(6):1032-1040 8. Christopher A. R´abago, PT, PhD, and Jason M. Wilken, PT, PhD. Application of a Mild Traumatic Brain Injury Rehabilitation Program in a Virtual Realty Environment: A Case Study . JNPT 2011;35: 185–193
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AuthorYong H. Kim, DC, DACNB, FABES, FIAMA Dipl.Ac. Archives
May 2021
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