Background: A 22-year-old, right-handed, left stick-holding, professional, male hockey player with a history of 5 concussions, presented with symptoms of headache, blurred vision, light headedness, difficulty falling asleep (for which he takes melatonin), and minor motion intolerance. He reported he sustained 2 concussions in a two-week period. Graded Symptom Checklist (GSC) severity was 13/162. Trails A (TA) and Trails B (TB) had scores of 16.4 seconds and 43.6 seconds respectively, Trails AB Difference (TB-A) was 27.2 seconds. Processing Speed (PS) coding score was 59. Simple Choice Reaction Time (scRT) and Choice Reaction Time (cRT) latency was 281 milliseconds and 400 milliseconds respectively.
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 somatosensory stimulation, visual evoked potentials, vision therapy, tilt table therapy, neuromuscular reeducation exercises, vestibular rehabilitation exercises, and off-vertical axis rotations including rotation in the roll plane.
Results: At the end of five days of treatment there were resolutions in GSC (-53%), decreased TA time (-16.4%), decreased TB time (-36.2%), TB-A decreased (-48%), increased PS score (+13.5%) and decreased scRT (-6.4%) and cRT (-8%) latency.
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, and off-vertical axis rotation including the roll plane, and intensive approaches to restoring neurological function in individuals suffering from mild traumatic brain injury (mTBI)
References: The authors would like to acknowledge and thank OVARD, Inc for the use of their Multi Axis Rotational Chair (MARC) in the treatment of this patient.