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Clinical characteristics and outcomes of treatment of the cervical spine in patients with persistent post-concussion symptoms: A retrospective analysis

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  • CT Clinical characteristics and outcomes of treatment of the cervical spine in patients with persistent post-concussion symptoms: A retrospective analysis

    http://www.mskscienceandpractice.com...lltext?rss=yes


    Highlights
    • The cervical spine may contribute to persistent post-concussion symptoms.
    • Physical examination is important to identify those with a cervicogenic component.
    • Pain on manual segmental testing appears a key feature of a cervicogenic component.
    • Neck treatment appears to benefit neck-related persistent post-concussion symptoms.

    Abstract

    Background


    Concussion is typically defined as a mild brain injury, and yet the brain is unlikely to be the only source of persistent post-concussion symptoms. Concurrent injury to the cervical spine in particular is acknowledged as a potential source of common persistent symptoms such as headache, dizziness and neck pain.

    Objectives


    To describe the cervical spine findings and outcomes of treatment in a series of patients with persistent post-concussion symptoms, and describe the clinical characteristics of a cervicogenic component when it is present.

    Design


    Retrospective chart review of a consecutive series of patients with concussion referred to a physiotherapist for cervical spine assessment.

    Method


    Patient charts for all patients over a calendar year referred by a concussion service provider to a physiotherapist for cervical spine assessment were de-identified and transferred to the research team. Clinical data were independently extracted by two research assistants and analysed using descriptive statistics.

    Results/findings


    Data were analysed from 46 patient charts. Those with a cervicogenic component (n = 32) were distinguished from those without a cervicogenic component (n = 14) by physical examination findings, particularly pain on manual segmental examination. Physiotherapy treatment of the cervicogenic component (n = 21) achieved improvements in function (mean increase of 3.8 in the patient-specific functional scale), and pain (mean decrease of 4.6 in the numeric pain-rating scale).

    Conclusions


    The clinical characteristics described give preliminary support to the idea that the cervical spine may contribute to persistent post-concussion symptoms, and highlight the value of physiotherapy assessment and treatment of the cervical spine following a concussive injury.
    Keywords:

    Brain concussion, Neck, Cervicogenic, Physiotherapy
    Last edited by Jo Bowyer; 12-08-2017, 08:56 PM.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

  • #2
    There has been a lot of discussion over the last couple of years amongst the UK docs and physios as to whether cervicogenic dizziness is a category. The jury is still out, awaiting sufficient evidence base.
    Last edited by Jo Bowyer; 12-08-2017, 08:57 PM.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

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