The Role of Mechanical Diagnosis and Therapy in the Management of Concussion

University at Buffalo (UB)

Status: Enrolling

Conditions: Mild Traumatic Brain Injury; Brain Concussion

Treatments: Behavioral: Physical Therapy

Study type: Observational

Funder types: Other

Identifiers

NCT05859815

STUDY00006666

Details and patient eligibility

About

The purpose of this study is to examine the role of a Mechanical Diagnosis and Therapy (MDT) examination in identifying participants diagnosed with concussion who display a directional preference compared to who don't display a directional preference.

Full description

Directional preference describes the clinical phenomenon where a specific direction of repeated movement and / or sustained position results in a clinically relevant improvement in symptoms. This improvement is usually accompanied by an improvement in function or mechanics or both. Its presence and relevance is determined over 2-3 visits. This study aims to identify the proportion of participants with concussion who present with a directional preference during the course of physical therapy. A secondary aim of this study is to investigate whether directional preference is associated with the eventual patient related outcomes following care.

Enrollment: 100 estimated patients

Sex: All

Ages: 13 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age = 13 - 65
• Complaints of neck pain, headache, or dizziness associated with a diagnosis of concussion or mild TBI
• Ability to read/write English
• Referral from physician

Exclusion criteria

• Age less than 13 or greater than 65
• Cause of symptoms is result of a work-related accident or motor vehicle accident
• Receiving concurrent treatment from a chiropractor or massage therapist
• Glasgow Coma Scale less than 12
• Lesion on head CT/MRI
• Focal neurological deficits associated with serious spinal pathology (fracture, infection, tumor, vertebrobasilar insufficiency)
• Inability to or unwilling to exercise as part of usual PT care
• Unable to read/write English
• History of osteopenia/osteoporosis or cancer

Trial design

100 participants in 2 patient groups

Directional preference responder

Description:

This group is comprised of participants who responded to repeated movements in a direction (e.g., neck flexion) that significantly improved their symptoms and/or their ability to move their head/neck.

Treatment:

Behavioral: Physical Therapy

Directional preference non-responder

Description:

This group is comprised of participants who did not respond to repeated movements in any specific direction that significantly improved their symptoms and/or their ability to move their head/neck.

Treatment:

Behavioral: Physical Therapy