OSU study follows 120 adolescents
For adolescents with symptoms following a concussion, starting physical therapy (PT) earlier provides outcomes similar to those of later PT, suggests a study in a recent issue of The Journal of Neurologic Physical Therapy (JNPT).
“Multimodal PT interventions administered by licensed physical therapists may be feasible and safe even within the first few weeks after injury to help facilitate prompt recovery and mitigate the onset of secondary effects from delayed treatment,” wrote Catherine Quatman-Yates, DPT, PhD, of Ohio State University. The study is part of a JNPT special issue on “Rehabilitation Management of Concussion,” highlighting research-driven changes geared toward promoting return to activity in young patients with concussion.
Researchers observed the timing of PT in concussion-related symptoms in 120 adolescents: 78 females and 42 males, median age 14 years. Physical therapy was classified as early (beginning 0 to 20 days after concussion) in 27.5 percent of patients, middle (21 to 41 days) in 32.5 percent, and late (42 days or after) in 40 percent.
The PT program consisted of progressive exercise; vestibular/oculomotor training (targeting inner ear/balance and visual symptoms); and cervical spine manual therapy, stretching, and strengthening exercises. This multimodal treatment was delivered by licensed physical therapists with special training in concussion treatment.
Whether started earlier or later, PT led to similar reductions in concussion-related symptoms. The number of sessions and duration of PT care were similar across groups. There was a low rate of adverse events, most of which were unrelated to PT.
Symptoms worsened in a few patients, more commonly in the late PT group. Some of these patients may have had concussion-related impairments not directly addressed by PT, such as anxiety, depression, or sleep problems.
The new study provides evidence that starting PT earlier is a safe and feasible approach for adolescents after concussion, with improved symptoms regardless of the timing of the intervention. “Introducing PT earlier in the recovery process may be beneficial in minimizing the potential burden of longer recovery trajectories,” Dr. Quatman-Yates and coauthors write. They emphasize the need for further research to determine PT’s role in the “optimal plan of care” for young patients with concussion.