About the Speaker

Dr Dawn Tan

Senior Principal Physiotherapist
Department of Physiotherapy
Singapore General Hospital

Dawn completed her Doctor of Clinical Physiotherapy with the University of Melbourne in 2011. She works with patients with neurological and vestibular disorders in the outpatient setting at the Singapore General Hospital. Dawn’s areas of research interests include stroke, Parkinson’s disease and vestibular rehabilitation.      


Track 12: Spectrum of Neurological Rehabilitation
Effectiveness of Vestibular Rehabilitation in the management of People with COncussion: A Systematic Review and Meta-Analysis
Date  :  Friday, 8 September 2017
Time  :  1530
Venue  :   Auditorium
Abstract  :   Mild traumatic brain injury or concussion is the second most common acquired neurologic disorder and a major public health concern, with rising global incidence. Dizziness and imbalance are common symptoms, and are difficult to manage. Vestibular rehabilitation appears to be a promising treatment given its established effectiveness in alleviating these symptoms in vestibular disorders. However, little is known of its efficacy in concussion.

This talk presents the results of a systematic review of the evidence supporting the efficacy of vestibular rehabilitation in patients post-concussion. Three out of 61 studies screened, comprising 149 participants, were included. The studies included one randomized controlled trial (RCT), retrospective cohort and case series. The quality score ranged from 12-15 (out of 16). The RCT demonstrated that a larger proportion of patients receiving combination of cervical and vestibular physiotherapy were more likely to be medically cleared to return to sport within 8 weeks than controls (73.3% vs 7.1%, 2=50.12, p<0.001). All studies reported improvement in dizziness severity (mean difference=19.3, 95%CI, 14.36-24.24) and balance (SMD=18.95, 95%CI,10.86-27.03) but not gait (SMD=1.54, 95%CI-2.18-5.26).

Vestibular rehabilitation appears to have positive outcomes on dizziness and balance but not gait in people post-concussion. However, results should be interpreted with caution due to the lack of large well-designed RCTs. This study highlighted the need for more research to determine the efficacy of vestibular rehabilitation in people post-concussion and factors which affect recovery.