A-63 Adolescent Males Demonstrate Greater Reduction in Dizziness Compared to Females after Vestibular Therapy Post-Concussion

Abstract

Abstract Purpose To examine sex differences in treatment response to vestibular therapy following subacute concussion. Methods This secondary analysis of a double-blind RCT recruited adolescent concussion patients with vestibular dysfunction and randomized to either a vestibular intervention group (VESTIB) or a behavioral management group (CONTROL). Participants completed The Dizziness Handicap Inventory (DHI) at initial evaluation, 2, and 4 weeks (±5 days) postintervention. The intervention was administered by concussion specialized vestibular therapists. A 2x2x3 repeated-measures GLM was conducted to examine sex differences (male, female) on DHI score at 3 time points (initial evaluation, 2 and 4 weeks postintervention) for both groups (CONTROL, VESTIB). Results VESTIB (n=12, 6F/6M) and CONTROL (n=15, 10F/5M) participants were 15.39+/-1.57 years old, injured within 21 days of initial evaluation. Results of the repeated-measures GLM supported a main effect for decrease in DHI (F[2,22]=30.47, p<.001, Wilks'Λ=.27, partial η2=.74) across visits. There was a significant group x gender x time interaction for DHI (F[2,22]=4.45, p=.024, Wilks'Λ=0.71, partial η2=.29), in which the males in the VESTIB group had a more significant decrease in DHI, while similar change in DHI was observed across genders for the CONTROL group. A main effect for group on DHI score fell short of significance (p=.06). Conclusions Our preliminary study suggests adolescent males may experience a faster resolution of dizziness compared to females' post-concussion when receiving vestibular therapy, but behavioral management supported similar dizziness reduction rates between sexes. Future research should examine mechanisms for differences in treatment response, such as adherence to treatment or underlying physiological differences.