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Vestibular/Ocular motor and balance assessment in sports related concussion A physical therapy approach to assess concussion

Markus M. Ernst

Statement of the Problem: The awareness of concussion especially in sports has increased significantly over the last decade. An estimated 1.6 to 3.8 million sports‐related concussions (SRC), occur each year in the United States. It is becoming more and more common for primary care physicians to refer patients with concussion symptoms to physical therapists who are trained “concussion specialists”. Many of these highly trained physical therapists use state of the art equipment like Videonystagmography (VNG) and computerized posturography (CPG) to assess athletes suffering from concussion. The vestibular system is a complex network that includes small sensory organs of the inner ear and neurological pathways to the brain stem, cerebellum, cerebral cortex, ocular system, and postural muscles. Methodology & Theoretical Orientation: Over the last 12 months, VNG (Difra) and CPG (NeuroCom) assessments have been collected and evaluated from 50 athletes (male and female) from different kind of sports. Findings: VNG and CPG assessments performed and analyzed by highly trained physical therapists are reliable assessment tools with high evidence for sports related concussions. Conclusion & Significance: Athletes in the USA, suffering SRC, use physical therapists as a first line of care for concussion assessment and rehabilitation. Vestibular/Ocular motor testing and computerized posturography can be an evidence-based tool to assess concussion in physical therapy. However, more research how vestibular/ocular motor testing and computerized posturography can be utilized to assess sports related concussion is necessary.

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