Abstract
Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.
Highlights
Concussion, a form of mild traumatic brain injury, affects more than 600 per 100,000 individuals each year [1]
No adverse events were reported when the electrical stimulation was applied to participants
When we looked at the recovery rate, no significant difference was found in the recovery rates of total symptoms severity between two groups (−1.49 ± 1.59 versus −1.2 ± 1.56, p = 0.32)
Summary
Concussion, a form of mild traumatic brain injury, affects more than 600 per 100,000 individuals each year [1]. If the concussion is not sport-related, most individuals recover completely within the first three months [5] [6]. Approximately 10% of athletes have persistent concussion symptoms beyond two weeks and up to 33% of non-athletes may have symptoms beyond three months [7]. The prolonged symptoms may indicate post-concussion syndrome (PCS). Post-concussion syndrome (PCS) is a complex disorder in which concussion symptoms last for weeks, months and, in rare cases, years. The majority of articles in the literature focus on the diagnosis of mild traumatic brain injury; the evidence for treating persistent symptoms after concussion remains scarce [8]
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