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Vestibular rehabilitation recovers teen from concussion

The exercise-based therapy was the treatment Shannon Kucwaj needed after she fell snowboarding.

Lorraine Kuczwaj never lets her daughter, Shannon, snowboard without a helmet. "It's like putting your seatbelt on," said Ms. Kucwaj, an ACI educator and nurse at Northwell.

Yet despite the safety rules she put in place, her 16-year-old daughter, Shannon, still fell while snowboarding and hit her head. Soon, she experienced headaches and dizziness, and had difficulty concentrating - symptoms of a concussion, an injury that affects how brain cells work.

"I was worried because a good friend of hers was out of school for a year [after a concussion]," said Lorraine, who took Shannon to see Rosanna Sabini, DO, medical director of Northwell's Concussion Program at Southside Hospital and an expert in brain injury medicine. "If you treat a concussion right away and address the problems that bring on the symptoms, you can make quick improvements."

Dr. Sabini created a plan for Shannon, including staying home from school for the first few days, limiting or avoiding activities that worsen symptoms, refraining from gym class and sports, and vestibular rehabilitation, which helps retrain the brain to compensate for problems with balance, decreasing dizziness and improving coordination.

quotation mark People come in well-informed, but some of the information they may have is incorrect, because it’s not up-to-date with what we know today. Concussion is a very treatable diagnosis, and people do get better from it.
Rosanna Sabini, DO

Treating concussions

According to Dr. Sabini, complete rest in a dark room is no longer the standard of care for concussions.

"A little movement helps the body and brain to heal," she said. But too much stimulation can worsen symptoms. She empowers patients to know - and honor - their limitations. "If you listen to your body and adjust, you're more likely to recover quicker than if you push through it."

"I was skeptical at first, because I didn't know what you could do for the brain," Lorraine said. But, she said Shannon's recovery was "dramatic," with her dizziness and headaches lessening in severity and length and her concentration improving within a few weeks. "We were extremely fortunate."

"People come in well-informed, but some of the information they may have is incorrect, because it's not up-to-date with what we know today," Dr. Sabini said. "Concussion is a very treatable diagnosis, and people do get better from it."

Role of vestibular rehabilitation in treating concussions

Studies have shown vestibular rehabilitation to be an effective modality for managing dizziness, vertigo and imbalance for post-concussion syndrome.

According to NeuroRehabilitation, careful consideration of the injury's acuity combined with effective management of comorbid conditions will optimize the result.

After a concussion, changes in brain processing and vestibular system (sensory system in inner ear) impact reflexes. During treatment, clinicians determine individualized plans, which can include:

  • Balance retraining, utilizing both static and dynamic balance exercises
  • Sensory organization training
  • Gaze stabilization exercises
  • Habituation exercises
  • Compensatory strategies
  • Canalith repositioning treatment (CRT or Epley Maneuver) for BPPV
  • Aerobic conditioning
  • A customized home exercise program
Northwell's concussion experts can get you back on track.
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