Vestibular, Oculomotor, and Head Repositioning Accuracy Deficits after Sport-Related Concussion: Implications for...

Area of Science:

• Sports Medicine
• Neurology
• Rehabilitation Science

Background:

• Concussion increases athletes' risk of re-injury upon return to play.
• Cervical spine, vestibular, and oculomotor deficits are observed post-concussion but their link to re-injury is unclear.

Purpose of the Study:

• To investigate the association between head repositioning accuracy (HRA) and vestibular/oculomotor symptoms with post-concussion injuries.
• To determine if HRA and symptom provocation predict future injury risk in adolescent athletes.

Main Methods:

• Prospective cohort study of adolescent athletes (ages 13-18) after concussion.
• Assessed head repositioning accuracy (HRA) and visiovestibular examination (VVE) for symptoms at return to play (RTP).
• Monitored injury incidence for one year using monthly surveys; analyzed data with Cox regression.

Main Results:

• Greater HRA error was significantly associated with a higher hazard of subsequent injury (HR: 1.46, P=0.03).
• Visio-vestibular examination symptom provocation was not significantly associated with subsequent injury risk (HR: 0.87, P=0.39).
• Forty-five athletes were included; 19 reported 24 injuries during follow-up.

Conclusions:

• Worse head repositioning accuracy may indicate an increased risk for post-concussion injuries.
• HRA is a feasible clinical assessment for identifying athletes at higher risk.
• HRA may guide further evaluation and rehabilitation before return to play decisions.