Effects of Vestibular Rehabilitation and Routine Physical Therapy in Athletes With Post Concussion Syndrome (PCS BESS IPRRS)

Lahore University of Biological and Applied Sciences

Status: Not yet enrolling

Conditions: Post Concussion Syndrome

Treatments: Other: Control Arm (Conventional Therapy); Other: Intervention 1

Study type: Interventional

Funder types: Other

Identifiers

NCT07401706

Syeda Farwa Aitbar (Registry Identifier)

DPT/ERB/25

Details and patient eligibility

About

This randomized controlled trial with a parallel design was conducted over six months at Ghurki Trust Teaching Hospital to compare the effects of Vestibular Rehabilitation and Routine Physical Therapy on stability, kinesiophobia, and return to sports in athletes with post-concussion syndrome. A total of 34 participants aged 12 to 30 years were enrolled based on specific diagnostic criteria. Non probability convenient sampling was used, followed by random allocation into experimental and control groups through computer generated sequencing and sealed envelope concealment. Single blinding was done, with participants unaware of their assigned intervention.

The experimental group received a Vestibular Rehabilitation program consisting of balance training, habituation exercises, and gaze stabilization, while the control group underwent Routine Physical Therapy involving ankle strategies and elliptical training. Both interventions were administered for 30 minutes, three times per week, over four weeks. Outcomes were measured pre- and post-intervention using validated tools: the Balance Error Scoring System (BESS) for postural stability, the Urdu version of the Tampa Scale of Kinesiophobia (TSK), and the Injury Psychological Readiness to Return to Sport Scale (I-PRRS). Data analysis was performed using SPSS version 26, employing appropriate parametric or non-parametric tests based on normality, with significance set at p < 0.05. Ethical approval was obtained, informed consent was secured, and all procedures adhered to established ethical standards.

Enrollment: 34 estimated patients

Sex: All

Ages: 12 to 30 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age 12 to 30 years
2. Fulfil the criteria of post concussion syndrome as highlighted by Tator et al.(2016)which requires presence of at least 3 or more persistent symptoms from standardized list
3. Sustained a mTBI in past 3 to 12 weeks
4. Having ongoing symptoms from list in PCSS that started 72 hrs or less after an impact
5. Exhibit objective deficits on standardized baseline examination enabling vestibular and ocular dysfunction

Exclusion criteria

• Have a chronic infectious disease.

  • Uncontrolled hypertension.
  • Other neurological disorders (not attributed to their primary diagnosis).
  • Cancer treatment (other than basal cell carcinoma), craniotomy, or refractory subdural hematoma.
  • Those on long term use of psychoactive drugs that compromise their ability to perform study activities
  • Those with pacemakers or elevated cardiovascular risk.
  • Ongoing litigation surrounding their injury.
  • Have been diagnosed with a severe brain injury prior to enrollment, or their post concussive symptoms have persisted beyond 12

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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34 participants in 2 patient groups

Vestibular Rehabilitation

Experimental group

Description:

The experimental group received a structured Vestibular Rehabilitation Program that included balance training, habituation exercises, and gaze stabilization exercises. These interventions were designed to improve postural stability, reduce dizziness and motion sensitivity, and enhance visual vestibular interaction. Each session lasted 30 minutes, was conducted three times per week, and continued for a total of four weeks under the supervision of a licensed physical therapist.

Treatment:

Other: Intervention 1

Routine Physical Therapy

Active Comparator group

Description:

The control group received Routine Physical Therapy, consisting of ankle strategy exercises to improve postural control through ankle musculature and coordination, along with elliptical training at sub-symptom threshold levels to promote aerobic conditioning. Similar to the experimental group, these sessions were performed for 30 minutes, three times per week, for four weeks, and were supervised by a licensed physical therapist.

Treatment:

Other: Control Arm (Conventional Therapy)