{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:01:20Z","timestamp":1784883680187,"version":"3.55.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ir J Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Concussions are increasingly common in older adults, with falls as the leading mechanism of injury. Older adults often experience prolonged recovery, and lingering post-concussive symptoms, perpetuating the cycle of elevated fall risk with significant public health implications. This highlights the need for age-specific concussion care incorporating multidomain assessment and individualized treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This retrospective case series explores the effect of a structured, stepwise evaluation and treatment framework on post-concussive symptoms in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five females over 60\u00a0years old with post-concussive symptoms completed the targeted concussion protocol as part of a larger prospective study. The protocol included modules addressing key rehabilitation domains: aerobic exercise to support autonomic regulation, brain-body integration exercises to improve motor control, and progressive visual-vestibular rehabilitation incorporating oculomotor training, postural stability challenges, and dual-tasking. Objective measures included the Post-Concussion Symptom Scale, Brain Injury Vision Symptom Survey (BIVSS), Dizziness Handicap Inventory, King Devick, a binocular vision screening tool, and an enhanced version of the Vestibulo-Oculomotor Screen (VOMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients demonstrated reduced symptom burden and functional improvements. Vestibular-oculomotor and motor control gains included a 53.9% average improvement in BIVSS scores, a mean 10-s reduction in King Devick time, and a 19.05-cm improvement in binocular vision measured via Brock String. Three patients normalized ocular alignment and near point convergence, while all showed improved Super Saccades performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participation in a multimodal protocol shows potential in reducing post-concussive impairments and symptoms in older adults. Larger studies are needed to establish effectiveness and feasibility in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11845-026-04575-w","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T08:05:03Z","timestamp":1784880303000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidomain rehabilitation for persistent concussion symptoms after falls in older adults: A case based review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6855-8906","authenticated-orcid":false,"given":"Lauren","family":"Ziaks","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Cumella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eden","family":"Schechter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary J.","family":"Kleban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Thomas","family":"Koc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"4575_CR1","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1089\/neu.2017.5371","volume":"35","author":"RC Gardner","year":"2018","unstructured":"Gardner RC, Dams-O\u2019Connor K, Morrissey MR, Manley GT (2018) Geriatric traumatic brain injury: epidemiology, outcomes, knowledge gaps, and future directions. 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A waiver of consent was obtained, and the patient\u2019s rights were protected. All institutional HIPAA policy requirements were met.","order":1,"name":"Ethics","label":"Ethics statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no financial conflicts of interest related to this study. However, the lead author developed the concussion protocol and some of the vision screening tools described in this manuscript. While these tools are not commercially licensed, their dissemination may contribute to professional recognition. This potential for perceived bias has been considered in the design and reporting of this study.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}