Longitudinal Vestibular and Oculomotor Impairments Among Amateur Athletes 1 Year Following Sport-Related Concussion: A Prospective Follow-Up

Abstract

Objectives:To investigate (i) the presence of vestibular and oculomotor impairments and (ii) the self-perceived effects of concussion-associated dizziness on health-related quality of life among amateur athletes 6 months and 1 year following sport-related concussion compared with nonconcussed, control athletes. Design: Prospective, matchedcohort study. Setting: Clinical assessment laboratory. Participants: Amateur athletes who were diagnosed with sport-related concussion within 1 week of injury, and sex-, age-, and activity-matched nonconcussed, control athletes. Main Measures: Participants were evaluated 6 months and 1 year following sport-related concussion and enrollment in the longitudinal study using the Vestibular and Oculo-Motor Screening and the Dizziness Handicap Inventory. We performed multivariate analyses of variance and chi-square analyses to compare concussion and control group scores at each study assessment. Results: Forty-seven participants with concussion and 47 control participants completed the study. The concussion group reported similar mean symptom provocation scores on the Vestibular and Oculo-Motor Screening and exhibited a similar near-point convergence distance compared with the control group at the 6-month and 1-year study assessments. The concussion and control groups had similar perceptions of the effects of dizziness on their health-related quality of life at both study assessments. Conclusion: Meaningful differences in vestibular and oculomotor symptom provocation and self-perceived effects of dizziness on everyday life were not observed between concussed and nonconcussed, control athletes 6 months and 1 year following sportrelated concussion.

Prospective study with specific Re-Assessment time points to determine time to recovery following a Sports-Related Concussion in university-aged student-athletes

“…Other studies have tracked recovery of VOM function (84) to the authors knowledge, this is the first study to track recovery of VOM function using the VOMS tool at regular intervals within the initial 14 days post-SRC and following the graded RTP process. Other studies using VOMS have identified VOM dysfunction delays return to learn (85), ability to start graded return to exercise (86) or being medically cleared to RTP (10,87).…”

Exploring Vestibular Ocular Motor Screening in Adults With Persistent Complaints After Mild Traumatic Brain Injury

“…Although initially developed as a screening tool for the purpose of distinguishing between concussed and healthy adolescents,1–7 there has been growing interest from clinical and research teams to use this tool outside the scope of screening and with different populations8 (eg, addition of VOMS to Military Acute Concussion Evaluation 2 [MACE2]9). Such examples include use in subacute and persistent time frames,8,10–15 use with adults,8,15,16 and also for tracking recovery 8,16–18. Given changes that may occur throughout recovery (eg, expected improvements in some or all symptoms between 2 and 4 weeks),19 and known differences in the vestibular and oculomotor systems that occur with aging,20,21 findings from research conducted in younger and athletic populations may not be generalizable to adults following mTBI, especially those with symptoms that persist beyond expected recovery timelines.…”

“…Such examples include use in subacute and persistent time frames, 8,[10][11][12][13][14][15] use with adults, 8,15,16 and also for tracking recovery. 8,[16][17][18] Given changes that may occur throughout recovery (eg, expected improvements in some or all symptoms between 2 and 4 weeks), 19 and known differences in the vestibular and oculomotor systems that occur with aging, 20,21 findings from research conducted in younger and athletic populations may not be generalizable to adults following mTBI, especially those with symptoms that persist beyond expected recovery timelines. Thus, further evidence is needed to support VOMS use outside its original scope including clinical use for nonathlete adults with concussion symptoms that persist beyond 3 weeks.…”