This educational graphic from the Commandant’s Safety Action Campaign (CSAC) informs the U.S Marine Corps of Blue Threats. (Cpl. Dominique Osthoff/U.S. Marine Corps)
People who receive physical therapy shortly after suffering concussions have better outcomes than those who wait longer to start rehabilitation programs, a recent analysis suggests.
Published in the Physical Therapy & Rehabilitation Journal, the study reports on a randomized trial of 203 adults diagnosed with a mild traumatic brain injury, or concussion, who were within two to 12 weeks from their injury.
Eighty-two were randomly selected for a group that received physical therapy within a week of entering the study — an average of 56 days after the injury occurred. The other 121 were given a brochure and began a physical therapy program six weeks after entering the study — an average of 99 days after being hurt.
Each patient received eight physical therapy sessions over six weeks, focusing on the cervical spine, cardiovascular system, and static and dynamic balance. Patients also did a home exercise program while in therapy.
At the end of the PT regimen, both groups filled out the Dizziness Handicap Inventory, a self-assessment of dizziness.
Those who participated in earlier physical therapy reported less dizziness, and their concussion symptoms improved sooner than their counterparts who waited for PT. Those in the earlier physical therapy group also regained their balance control more quickly and had quicker reaction times than their counterparts who delayed rehab. Those who waited longer to start physical therapy did not improve in balance reaction times and even got worse in some measures of underlying balance.
“There seems to be a window of opportunity within two months,” Laurie King, a professor of neurology at Oregon Health & Science University School of Medicine and the study’s senior author, said in a news release. “After that point, the brain compensates in a way that’s not good.”
People usually rely on both vision and the vestibular system in the inner ear to stay balanced, the researchers say. However, the patients in the delayed PT group displayed symptoms of relying primarily on vision to maintain balance, the researchers write, while those who got therapy sooner seemed to recover their vestibular balance more quickly.
The study suggests that for concussions, physical therapy should be offered sooner rather than later if symptoms continue past the normal window of recovery (two to four weeks), the researchers conclude.
