{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:47:17Z","timestamp":1777877237993,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T00:00:00Z","timestamp":1614988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Vestibular dysfunction, characterized by nausea, dizziness, imbalance, and\/or gait disturbance, represents an important sport-related concussion (SRC) subtype associated with prolonged recovery. Vestibular physical therapy promotes recovery; however, the benefit of earlier therapy is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Earlier vestibular therapy for young athletes with SRC is associated with earlier return to play (RTP), return to learn (RTL), and symptom resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients aged 5 to 23 years with SRC who initiated vestibular rehabilitation therapy (VRT) from January 2019 to December 2019 were included and patient records were reviewed. Therapy initiation was defined as either early, \u226430 days postinjury, or late (&gt;30 days). Univariate comparisons between groups, Kaplan-Meier plots, and multivariate Cox proportional hazard modeling were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 23 patients (10 early, 13 late) aged 16.14 \u00b1 2.98 years and 43.5% were male patients. There was no difference between group demographics or medical history. Median initial total and vestibular symptom scores were comparable between groups. The late therapy group required additional time to RTP (110 days [61.3, 150.8] vs 31 days [22.5, 74.5], P = 0.03) and to achieve symptom resolution (121.5 days [71, 222.8] vs 54 days [27, 91], P = 0.02), but not to RTL (12 days [3.5, 26.5] vs 17.5 days [8, 20.75], P = 0.09). Adjusting for age and initial total symptom score, earlier therapy was protective against delayed symptom resolution ( P = 0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This pilot study suggests that initiating VRT within the first 30 days after SRC is associated with earlier RTP and symptom resolution. Further prospective trials to evaluate if even earlier VRT should be pursued to further improve recovery time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Clinicians should screen for vestibular dysfunction and consider modifying follow-up schedules after SRC to initiate VRT within a month of injury for improved outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1941738121998687","type":"journal-article","created":{"date-parts":[[2021,3,6]],"date-time":"2021-03-06T06:44:01Z","timestamp":1615013041000},"page":"573-579","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["A Pilot Study Evaluating the Timing of Vestibular Therapy After Sport-Related Concussion: Is Earlier Better?"],"prefix":"10.1177","volume":"13","author":[{"given":"Ranbir","family":"Ahluwalia","sequence":"first","affiliation":[{"name":"Florida State University College of Medicine, Tallahassee, Florida"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Miller","sequence":"additional","affiliation":[{"name":"Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fakhry M.","family":"Dawoud","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Quillen College of Medicine, East Tennessee State University, Mountain Home, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose O.","family":"Malave","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Tyson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Bonfield","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron M.","family":"Yengo-Kahn","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Vanderbilt Sport Concussion Center, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,6]]},"reference":[{"key":"bibr1-1941738121998687","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0b013e3181dde568"},{"key":"bibr2-1941738121998687","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000185"},{"key":"bibr3-1941738121998687","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2019.03.011"},{"key":"bibr4-1941738121998687","volume-title":"The Relationship Between the Glasgow Coma Scale and the Functional Independence Measure in a Sample of 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