The effect of a home exercise program on visio-vestibular function in concussed pediatric patients
BackgroundA visio-vestibular home exercise program (VV-HEP) can provide an equitable and cost-effective method for therapy targeted towards visio-vestibular deficits that are common following concussion. The effects of a VV-HEP on improving concussion symptoms and visio-vestibular function are uncle...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Sports and Active Living |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fspor.2023.1064771/full |
| _version_ | 1811160806158499840 |
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| author | Patricia R. Roby Olivia E. Podolak Matthew Grady Matthew Grady Kristy B. Arbogast Kristy B. Arbogast Kristy B. Arbogast Christina L. Master Christina L. Master Christina L. Master |
| author_facet | Patricia R. Roby Olivia E. Podolak Matthew Grady Matthew Grady Kristy B. Arbogast Kristy B. Arbogast Kristy B. Arbogast Christina L. Master Christina L. Master Christina L. Master |
| author_sort | Patricia R. Roby |
| collection | DOAJ |
| description | BackgroundA visio-vestibular home exercise program (VV-HEP) can provide an equitable and cost-effective method for therapy targeted towards visio-vestibular deficits that are common following concussion. The effects of a VV-HEP on improving concussion symptoms and visio-vestibular function are unclear.PurposeDetermine the effect of VV-HEP on symptoms and visio-vestibular function in concussed pediatric patients.MethodsThis study included 527 patients [294 female (55.8%); age = 14.4 ± 2.1 years] reporting to a specialty care concussion center within 28 days of injury and for a first follow-up within 60 days of injury. Patients completed the Post-Concussion Symptom Inventory (PCSI) and Visio-Vestibular Examination (VVE). Patients were prescribed the VV-HEP at initial visit, with exercises including saccades, gaze stability, convergence, and balance, and instructed to complete these 1–2 times/day. At follow-up, patients self-reported their VV-HEP progress as (1) has not done, (2) in progress, or (3) completed. Primary outcomes included VV-HEP progress at follow-up, PCSI endorsement and severity, VVE subtests (normal/abnormal), and total VVE score (abnormal = 2 + abnormal subtests). Kruskal-Wallis tests and chi-square were used to determine if concussion symptoms or the proportion of abnormal VVE outcomes, respectively, were associated with VV-HEP status. Post-hoc pairwise comparisons with Bonferonni corrections were used to determine concussion symptom (α = 0.017 a priori) and VVE (α = 0.005 a priori) differences in VV-HEP status.ResultsAt follow-up, patients who had completed the VV-HEP reported lower symptom endorsement (median = 1, IQR = 0–3) and lower symptom severity (median = 1, IQR = 0–4) relative to patients who had not started the VV-HEP (endorsement median = 7, IQR = 1–13, p < 0.0001; severity median = 15.5, IQR = 2–32.5, p < 0.0001) and those in progress (endorsement median = 8, IQR = 3–14, p < 0.0001; severity median = 15, IQR = 4–30, p < 0.0001). A lower proportion of patients who completed the VV-HEP reported with abnormal vestibular-ocular reflex (22.2%), tandem gait (0%), and total VVE score (22.2%) relative to those who had not started or those in progress (p < 0.005).ConclusionOur findings indicate that patients who completed the VV-HEP had lower symptom burden and improved visio-vestibular function relative to those who did not start or were in progress. This suggests that a VV-HEP can effectively reduce visio-vestibular dysfunction following concussion and may serve as a means to minimize inequities in access to care. |
| first_indexed | 2024-04-10T06:03:47Z |
| format | Article |
| id | doaj.art-504f098bf64144fd9e23b99cd5cbda03 |
| institution | Directory Open Access Journal |
| issn | 2624-9367 |
| language | English |
| last_indexed | 2024-04-10T06:03:47Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Sports and Active Living |
| spelling | doaj.art-504f098bf64144fd9e23b99cd5cbda032023-03-03T04:58:51ZengFrontiers Media S.A.Frontiers in Sports and Active Living2624-93672023-03-01510.3389/fspor.2023.10647711064771The effect of a home exercise program on visio-vestibular function in concussed pediatric patientsPatricia R. Roby0Olivia E. Podolak1Matthew Grady2Matthew Grady3Kristy B. Arbogast4Kristy B. Arbogast5Kristy B. Arbogast6Christina L. Master7Christina L. Master8Christina L. Master9Center for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesCenter for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesSports Medicine Performance Center, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesCenter for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesDivision of Emergency Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesCenter for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United StatesSports Medicine Performance Center, The Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesBackgroundA visio-vestibular home exercise program (VV-HEP) can provide an equitable and cost-effective method for therapy targeted towards visio-vestibular deficits that are common following concussion. The effects of a VV-HEP on improving concussion symptoms and visio-vestibular function are unclear.PurposeDetermine the effect of VV-HEP on symptoms and visio-vestibular function in concussed pediatric patients.MethodsThis study included 527 patients [294 female (55.8%); age = 14.4 ± 2.1 years] reporting to a specialty care concussion center within 28 days of injury and for a first follow-up within 60 days of injury. Patients completed the Post-Concussion Symptom Inventory (PCSI) and Visio-Vestibular Examination (VVE). Patients were prescribed the VV-HEP at initial visit, with exercises including saccades, gaze stability, convergence, and balance, and instructed to complete these 1–2 times/day. At follow-up, patients self-reported their VV-HEP progress as (1) has not done, (2) in progress, or (3) completed. Primary outcomes included VV-HEP progress at follow-up, PCSI endorsement and severity, VVE subtests (normal/abnormal), and total VVE score (abnormal = 2 + abnormal subtests). Kruskal-Wallis tests and chi-square were used to determine if concussion symptoms or the proportion of abnormal VVE outcomes, respectively, were associated with VV-HEP status. Post-hoc pairwise comparisons with Bonferonni corrections were used to determine concussion symptom (α = 0.017 a priori) and VVE (α = 0.005 a priori) differences in VV-HEP status.ResultsAt follow-up, patients who had completed the VV-HEP reported lower symptom endorsement (median = 1, IQR = 0–3) and lower symptom severity (median = 1, IQR = 0–4) relative to patients who had not started the VV-HEP (endorsement median = 7, IQR = 1–13, p < 0.0001; severity median = 15.5, IQR = 2–32.5, p < 0.0001) and those in progress (endorsement median = 8, IQR = 3–14, p < 0.0001; severity median = 15, IQR = 4–30, p < 0.0001). A lower proportion of patients who completed the VV-HEP reported with abnormal vestibular-ocular reflex (22.2%), tandem gait (0%), and total VVE score (22.2%) relative to those who had not started or those in progress (p < 0.005).ConclusionOur findings indicate that patients who completed the VV-HEP had lower symptom burden and improved visio-vestibular function relative to those who did not start or were in progress. This suggests that a VV-HEP can effectively reduce visio-vestibular dysfunction following concussion and may serve as a means to minimize inequities in access to care.https://www.frontiersin.org/articles/10.3389/fspor.2023.1064771/fullvisionvestibulartherapyadolescentsymptom |
| spellingShingle | Patricia R. Roby Olivia E. Podolak Matthew Grady Matthew Grady Kristy B. Arbogast Kristy B. Arbogast Kristy B. Arbogast Christina L. Master Christina L. Master Christina L. Master The effect of a home exercise program on visio-vestibular function in concussed pediatric patients Frontiers in Sports and Active Living vision vestibular therapy adolescent symptom |
| title | The effect of a home exercise program on visio-vestibular function in concussed pediatric patients |
| title_full | The effect of a home exercise program on visio-vestibular function in concussed pediatric patients |
| title_fullStr | The effect of a home exercise program on visio-vestibular function in concussed pediatric patients |
| title_full_unstemmed | The effect of a home exercise program on visio-vestibular function in concussed pediatric patients |
| title_short | The effect of a home exercise program on visio-vestibular function in concussed pediatric patients |
| title_sort | effect of a home exercise program on visio vestibular function in concussed pediatric patients |
| topic | vision vestibular therapy adolescent symptom |
| url | https://www.frontiersin.org/articles/10.3389/fspor.2023.1064771/full |
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