Document Type

Case Report


Physical Therapy & Rehabilitation Science

Degree Name

DPT (Doctor of Physical Therapy)

Session and Year of Graduation

Fall 2019


Frey Law, Laura


Background: Prolonged Concussive symptoms following an acute injury, known as Post-Concussion Syndrome (PCS) are beginning to be discussed in literature. There has been recent evidence produced on the benefits of aerobic exercise and vestibular rehabilitation to assess and manage this unique patient population. Purpose: The purpose of this case study is to describe a protracted recovery of a patient experiencing PCS and provide specific assessment tools as well as interventions to help guide rehabilitation strategies following a concussion. Case Description: A 33-year-old female arrived at physical therapy 3-weeks after experiencing a mild traumatic brain injury (mTBI), following a motor vehicle accident (MVA). She was experiencing constant headaches, dizziness, nausea, right-sided neck pain, difficulty sleeping, decreased concentration, fatigue, increased irritability and frustration, and decreased function in daily responsibilities. Interventions: The patient received 22 sessions of physical therapy over a 12-week period, while also receiving psychological services. The interventions included functional strengthening, manual therapy, sub-symptom aerobic exercise, vestibular and oculomotor training, balance interventions, and work simulated tasks. Outcomes: The patient was evaluated using the Vestibular/ Ocular Motor Screening (VOMS) assessment tool. The patient improved from symptomatic with all items of the VOMS to mild headache symptoms with 3 items of the assessment. In addition, on initial evaluation the patient reported 7 on a 0-10 cm on a visual analog scale (VAS) for neck pain, which was reduced to 0/10. The patient returned to previous level of employment following physical therapy rehabilitation demonstrating improvement in overall function. Discussion: Through the physical therapy plan of care the patient demonstrated improvements with reduced frequency and severity of headaches with accompanying dizziness, increased tolerance to activity, and decreased neck pain, and improved concentration. This case study provides an example of a positive outcome following outpatient physical therapy for a patient with prolonged PCS, with full return to work and pre-injury activity.


Post-concussion syndrome; traumatic brain injury; physical therapy; rehabilitation; vestibular rehabilitation; aerobic exercise


11 pages


Copyright © 2019 Ryan Griffith