Improvement in Symptom Severity, Cognitive Assessment, Processing Speed, Reaction Time and Visual Acuity in a Professional Hockey Player with a Prior Concussion

Background: A 23-year-old, male, right hand dominant/left-hand stick holding, hockey player with a history of concussion presents with occasional lightheadedness, fogginess, and a constant feeling of being in a “daze”. His Graded Symptom Checklist (GSC) severity was 48/162. His Standard Assessment of Concussion (SAC) was 26/30, Trails A (TA) 13.6 seconds, Trails B (TB) was 31.2, Trails AB difference (TA-B) was 17.6. His Simple Reaction Time (sRT) was 300 milliseconds, Processing Speed (PS) was 83 symbols matched correctly in 2 minutes, Choice Reaction Time (cRT) latency was 387 milliseconds and his Visual Acuity line difference (VA) was 1.2 on intake.

Methods: A five-day, multimodal program of receptor based neurological rehabilitation was administered three times per day, one hour per session. Each session consisted of electrical non-invasive nerve stimulation, neuromuscular reeducation exercises, vision therapy exercises, vestibular rehabilitation exercises, hand-eye coordination exercises, and off-vertical axis rotations.

Results: Following conclusion of five days of treatment there were significant improvements in GSC (-95.9%), SAC (+10.4%), TA (-22.1%), TB (34.6%), TB-A (-31.4%), PS (+8.8%), sRT latency (-21.33%), cRT latency (-13.2%), and VA (-83.33%).

Conclusion: Short duration, multimodal, intensive programs of receptor based neurological rehabilitation may be a viable method to improve neurological integrity and performance in individuals with Post-Concussive Syndrome. The authors suggest further investigation into short duration, multi-modal, intensive approaches to restoring neurological function in individuals suffering from mild traumatic brain injury (mTBI)