Does Exercise Increase Vestibular and Ocular Motor Symptom Detection After Sport-Related Concussion?

Area of Science:

• Sports Medicine
• Neurology
• Ophthalmology

Background:

• Postconcussive vestibular and ocular motor symptoms are common after concussion and can prolong recovery.
• The Vestibular/Ocular Motor Screening (VOMS) is a standard tool, but may not detect symptoms provoked by exertion.
• Supervised exercise challenges (SECs) can elicit symptoms related to physical exertion.

Purpose of the Study:

• To evaluate if performing the VOMS after an SEC increases symptom provocation compared to a VOMS at rest.
• To determine if SECs enhance the detection of vestibular and ocular motor symptoms in athletes post-concussion.

Main Methods:

• Thirty-six athletes (ages 10-18) within 30 days of concussion participated.
• Participants underwent VOMS assessments both at rest and immediately following an SEC.
• Statistical analyses included Wilcoxon ranked sum tests and McNemar's test to compare symptom scores and frequencies.

Main Results:

• Significant increases in VOMS symptom provocation scores were observed post-SEC compared to pre-SEC.
• The post-SEC VOMS identified more athletes (80.6%) with positive symptoms than the pre-SEC VOMS (58.3%).
• The SEC-VOMS identified athletes who were negative at rest but positive after exertion.

Conclusions:

• Performing an SEC prior to VOMS assessment can improve the detection of vestibular and ocular motor symptoms.
• This method may identify symptoms missed by a VOMS performed solely at rest.
• SEC-enhanced VOMS offers a more comprehensive assessment of postconcussive symptoms.