Open AccessIntegration of Vision and Vestibular Therapy for Vestibulo-Ocular Post-Concussion Disorder – A Case Study
Author(s) -
Lauren Ziaks,
Rosemary Giardina,
Anne Kloos
Publication year - 2019
Publication title -
the internet journal of allied health sciences and practice
Language(s) - English
Resource type - Journals
ISSN - 1540-580X
DOI - 10.46743/1540-580x/2019.1754
Subject(s) - concussion , vestibular system , physical medicine and rehabilitation , medicine , physical therapy , rehabilitation , balance (ability) , audiology , poison control , injury prevention , environmental health
Purpose: The purpose of this case study was to examine the effectiveness of integrated vision and vestibular therapy for an individual with oculomotor and vestibular system impairments secondary to a concussion further defined as vestibulo-ocular post-concussion disorder. A secondary purpose was to suggest an appropriate timeline to introduce vision therapy and integrate vestibular rehabilitation therapy based on protocol used in an outpatient concussion rehabilitation clinic. Method This was a case study on a 16-year-old female with protracted concussion recovery. Treatment consisted of 9 in-clinic visits for vision therapy with the final 6 visits addressing vision and vestibular deficits. A home exercise program supplemented the weekly clinic sessions. Outcomes measures included the Activity-Specific Balance Confidence Scale (ABC Scale), Brain Injury Vision Symptom Survey (BIVSS), Convergence Insufficiency Symptom Survey (CISS), Dizziness Handicap Inventory (DHI), and Post-Concussion Symptom Scale (PCSS). Improvements in vision and vestibular function were assessed with a comprehensive visuo-vestibular re-evaluation at discharge and 5 month follow up. Results:Improvements in oculomotor control, vergences, vestibular function, and symptomology were reported and measured at discharge and corresponded with clinically meaningful functional outcome improvements. The patient improved from 68% to 96.88% on the ABC ( Conclusion: Results from this case study suggest integrated vision and vestibular therapy, when done in the appropriate timeline, may be used to efficiently and effectively manage vestibulo-ocular post-concussion disorder.