Background: Concussion symptoms following an acute mild traumatic brain injury (mTBI) persisting for more than 3 months is known as Post Concussion Syndrome (PCS). Research on treatment for PCS and concussion has increased in recent years with strong support for sub-symptomatic aerobic exercise, vestibular rehabilitation, oculomotor therapy, and patient education. Purpose: The purpose of this case study is to describe the symptoms, treatment, and outcomes of a patient experiencing PCS and provide an assessment of case-specific interventions to help guide future treatment of patients with PCS. Case Description: A 48-year-old female-initiated therapy 8 months after experiencing an mTBI following an accident at work. Since the injury, she had been experiencing nine mTBI symptoms of sufficient severity to prevent her return to most activities of daily living including grocery shopping, reading, watching television, reading on her phone, and returning to work. Interventions: The patient received 12 sessions of physical therapy over a 7-week time frame while receiving services from occupational therapy, speech therapy, and counseling for injury-related issues. Physical Therapy interventions included patient education, vestibular training, oculomotor training, balance training, and sub-symptomatic aerobic exercise. Patient education and stress-reducing techniques were provided as adjuncts to the evidence-based interventions. Outcomes: At week 6, the patient was able to fully complete the Modified Clinical Test of Sensory Interaction on Balance (mod CTSIB), was less symptomatic with the Functional Gait Assessment (FGA) score of 17/30 and was better able to verbalize vestibular sensations with the Vestibular Ocular Motor Screening (VOMS). At week 14 the patient was able to score 24/30 on the FGA. Discussion: The patient had a challenging timeline of not starting therapy interventions for her concussion symptoms for 8 months after the initial event. The patient was able to tolerate the gradual introduction of graze stabilization and balance exercises to integrate oculomotor and vestibular activity to address her movement intolerance. She was unable to tolerate progressive overground walking but successfully tolerated seated aerobic training with a recumbent cross-trainer. Patient education and stress-reducing techniques were used successfully with this patient, however, there is limited evidence to support this method at this time. Conclusion: Patient and symptom specific interventions should be chosen for treatment of patient with PCS. The use of a grade aerobic protocol such as the Buffalo Concussion Treadmill Test would have been beneficial to objectively track her activity tolerance, but other means were used in this case. An interdisciplinary care was used and was beneficial to this patient and would likely be beneficial for other cases in the future.
Dissertation
Physical Therapy Management of a Female Patient with Post-Concussion Syndrome with Movement Intolerance: A Case Report
University of Iowa
Doctor of Physical Therapy (DPT) , University of Iowa
Autumn 2023
Free to read and download, Open Access
Abstract
Details
- Title: Subtitle
- Physical Therapy Management of a Female Patient with Post-Concussion Syndrome with Movement Intolerance: A Case Report
- Creators
- Keely Paus - University of Iowa
- Contributors
- Shauna Dudley-Javoroski (Advisor) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Case Report
- Degree Awarded
- Doctor of Physical Therapy (DPT) , University of Iowa
- Degree in
- Physical Therapy & Rehabilitation Science
- Date degree season
- Autumn 2023
- Publisher
- University of Iowa
- Number of pages
- 11 pages
- Copyright
- Copyright © 2023 Keely Paus
- Language
- English
- Academic Unit
- Doctor of Physical Therapy Case Reports
- Record Identifier
- 9984560249302771
Metrics
3 Record Views