Abstract
Rehabilitation for athletes with postconcussion syndrome requires emphasis on both
cognitive and physical rest with a gradual return to activity and sports. As the athlete
becomes more active, the rehabilitation and sport professional should pay close attention
to symptoms of concussion, like headache, dizziness, nausea, and difficulty concentrating.
The Zurich Consensus Statement on Concussion in Sport provides a systematic approach
to increasing the intensity of physical activity while attending to postconcussion
symptoms. During the incident that led to a concussion, the injured athlete may have
incurred injuries to the vestibular and balance system, which are not directly related
to concussion. These conditions are best addressed by professionals with specific
training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal
positional vertigo is a condition in which otoconia particles in the inner ear dislodge
into the semicircular canals, resulting in severe vertigo and imbalance. This condition
frequently resolves with a few sessions with a vestibular therapist and a home exercise
program. In conditions like gaze instability, motion sensitivity, impaired postural
control, and cervicogenic dizziness, improvement is more gradual and requires longer
follow-up with a physical therapist. In all of these conditions, it is important to
consider that the patient with postconcussion syndrome will likely recover more slowly
than others and should be monitored for symptoms of postconcussion syndrome throughout
intervention.
Keywords
Postconcussion syndrome - treatment - vertigo - dizziness - postural instability -
gaze stability - benign paroxysmal positional vertigo - cervicogenic dizziness - graduated
exertion
