Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case
Background: The appropriate detection and therapy of concussion symptoms are of great importance to avoid long-term impairment and absence from pre-concussive activities, such as sport, school or work. Post-traumatic headache and dizziness are known as risk factors of persistent symptoms after a con...
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doaj-ac06986b405f4592a9915f03b70b2c622020-11-25T01:58:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-11-011010.3389/fneur.2019.01200476567Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical CaseViviana Mucci0Viviana Mucci1Cornelia Meier2Mario Bizzini3Mario Bizzini4Fausto Romano5Fausto Romano6Daniel Agostino7Alessandra Ventura8Giovanni Bertolini9Giovanni Bertolini10Nina Feddermann-Demont11Nina Feddermann-Demont12Swiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandDepartment of Neurology, University Hospital and University of Zurich, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandHuman Performance Lab, Schulthess Clinic, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandDepartment of Neurology, University Hospital and University of Zurich, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandDepartment of Neurology, University Hospital and University of Zurich, Zurich, SwitzerlandSwiss Concussion Center, Schulthess Clinic, Zurich, SwitzerlandDepartment of Neurology, University Hospital and University of Zurich, Zurich, SwitzerlandBackground: The appropriate detection and therapy of concussion symptoms are of great importance to avoid long-term impairment and absence from pre-concussive activities, such as sport, school or work. Post-traumatic headache and dizziness are known as risk factors of persistent symptoms after a concussion. Dizziness has even been classified as a predictor for symptom persistence. One type of dizziness, which has never been considered is visually induced dizziness (VID) often develops as a consequence of vestibular impairment. This manuscript presents the clinical case of a 25-year-old male, professional ice hockey player, whereby a therapeutic approach to VID after concussion is demonstrated.Case: A detailed interdisciplinary clinical and laboratory-assisted neurological, neurovestibular and ocular-motor examination was performed 20 days post-concussion, which indicated VID symptoms. Thus, the player qualified for a 5-day combined vestibular, balance and optokinetic therapy, which aimed to reduce the player's increased sensitivity to visual information. Each treatment day consisted of two sessions: vestibular/ocular-motor training and exposure to optokinetic stimuli combined with postural control exercises. The optokinetic stimulus was delivered in the form of a rotating disk. VID symptoms were recorded daily via posturography and a visual analog scale prior to the optokinetic sessions. The player improved over the course of each treatment day and was able to return to ice hockey 15 days after the final treatment session. Three months later the player reported no symptoms in the follow up questionnaire.Conclusion: The combination of vestibular, balance and optokinetic therapy led to remission of VID symptoms in a professional ice hockey player after multiple concussions, within a short time frame after his last concussion. Thus, this case study highlights the significant benefit of treating post-concussive VID symptoms utilizing a multi-modal approach.https://www.frontiersin.org/article/10.3389/fneur.2019.01200/fullconcussionice hockeyoptokineticdizzinessvisually induced dizzinessvestibular rehabilitation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Viviana Mucci Viviana Mucci Cornelia Meier Mario Bizzini Mario Bizzini Fausto Romano Fausto Romano Daniel Agostino Alessandra Ventura Giovanni Bertolini Giovanni Bertolini Nina Feddermann-Demont Nina Feddermann-Demont |
spellingShingle |
Viviana Mucci Viviana Mucci Cornelia Meier Mario Bizzini Mario Bizzini Fausto Romano Fausto Romano Daniel Agostino Alessandra Ventura Giovanni Bertolini Giovanni Bertolini Nina Feddermann-Demont Nina Feddermann-Demont Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case Frontiers in Neurology concussion ice hockey optokinetic dizziness visually induced dizziness vestibular rehabilitation |
author_facet |
Viviana Mucci Viviana Mucci Cornelia Meier Mario Bizzini Mario Bizzini Fausto Romano Fausto Romano Daniel Agostino Alessandra Ventura Giovanni Bertolini Giovanni Bertolini Nina Feddermann-Demont Nina Feddermann-Demont |
author_sort |
Viviana Mucci |
title |
Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case |
title_short |
Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case |
title_full |
Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case |
title_fullStr |
Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case |
title_full_unstemmed |
Combined Optokinetic Treatment and Vestibular Rehabilitation to Reduce Visually Induced Dizziness in a Professional Ice Hockey Player After Concussion: A Clinical Case |
title_sort |
combined optokinetic treatment and vestibular rehabilitation to reduce visually induced dizziness in a professional ice hockey player after concussion: a clinical case |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-11-01 |
description |
Background: The appropriate detection and therapy of concussion symptoms are of great importance to avoid long-term impairment and absence from pre-concussive activities, such as sport, school or work. Post-traumatic headache and dizziness are known as risk factors of persistent symptoms after a concussion. Dizziness has even been classified as a predictor for symptom persistence. One type of dizziness, which has never been considered is visually induced dizziness (VID) often develops as a consequence of vestibular impairment. This manuscript presents the clinical case of a 25-year-old male, professional ice hockey player, whereby a therapeutic approach to VID after concussion is demonstrated.Case: A detailed interdisciplinary clinical and laboratory-assisted neurological, neurovestibular and ocular-motor examination was performed 20 days post-concussion, which indicated VID symptoms. Thus, the player qualified for a 5-day combined vestibular, balance and optokinetic therapy, which aimed to reduce the player's increased sensitivity to visual information. Each treatment day consisted of two sessions: vestibular/ocular-motor training and exposure to optokinetic stimuli combined with postural control exercises. The optokinetic stimulus was delivered in the form of a rotating disk. VID symptoms were recorded daily via posturography and a visual analog scale prior to the optokinetic sessions. The player improved over the course of each treatment day and was able to return to ice hockey 15 days after the final treatment session. Three months later the player reported no symptoms in the follow up questionnaire.Conclusion: The combination of vestibular, balance and optokinetic therapy led to remission of VID symptoms in a professional ice hockey player after multiple concussions, within a short time frame after his last concussion. Thus, this case study highlights the significant benefit of treating post-concussive VID symptoms utilizing a multi-modal approach. |
topic |
concussion ice hockey optokinetic dizziness visually induced dizziness vestibular rehabilitation |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.01200/full |
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