A-13 A Description of Patient Characteristics and Predictors for Vestibular Therapy Referral Following Concussion

Abstract

Abstract Purpose: To describe patient characteristics and predictors for vestibular therapy referral among concussion patients with vestibular and ocular motor dysfunction. Methods: Medical records from 1083 patients (12-50 yrs) seeking care for concussion within 30 days of injury were extracted. Demographics and clinical outcomes (symptoms, vestibular/oculomotor change scores, and state anxiety) were described and associations between referral and these variables were explored with chi-square analyses and a logistic regression. Results: Twenty-one percent (229/1083, Mage = 22.34, SD = 10.26 yrs, 64% female) of patients received vestibular therapy referral. The most frequent risk factors included symptom burden (94%), vestibular/ocular motor symptom provocation (88%), convergence insufficiency (73%), state anxiety (66%), and post-traumatic migraine (PTM) (52%). The LR (χ2(13, 1083) = 142.24, p < 0.001) revealed vestibular/ocular motor provocation (adjusted OR = 3.88, p < 0.001) showed the greatest likelihood for referral followed by symptom burden (adjusted OR = 2.78, p < 0.001), convergence insufficiency (adjusted OR = 2.77, p < 0.001), first clinical visit longer than one week (adjusted OR = 1.90, p < 0.001), and on-field dizziness (adjusted OR = 1.51, p = 0.03). Conclusions: Approximately 25% of concussed patients receive vestibular therapy. These patients have more vestibular/ocular motor impairment, dizziness, and overall symptom burden.