Improvements in Cognition and Stability Scores Following Neurological Rehabilitation for a 68-year-old Female Patient with Post-Concussive Syndrome
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1
Plasticity Brain Centers, United States
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2
Carrick Institute, United States
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3
University of Central Florida, United States
Presentation: A 68-year-old female patient presented to Plasticity Brain Centers for evaluation and treatment of post-concussive syndrome (PCS) after being struck, as a pedestrian, by a motor vehicle. She presented with the following symptomatology: memory lapses, issues with processing speed, balance issues, and difficulty walking.
Findings: When asked to rate her symptoms on a graded symptom checklist (GSC) (Simon 2017), she reported a score of 67. On the standardized assessment of concussion (SAC) on the C3Logix assessment, she scored 19 out of 30. A Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing balance and stability, on a solid and foamed surface, with eyes opened and closed with the head in multiple positions. The average stability score was 34.506%.
Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions (Carrick 2017). Each session consisted of repetitive peripheral somatosensory stimuli, neuromuscular reeducation exercises, vestibular rehabilitation exercises, cognitive exercises, orthoptic exercises, and off-vertical axis rotation (Gdowski 1999) utilizing a multi-axis rotational chair (MARC).
Outcome: Upon exit, the symptom severity score decreased to 25 (-62.6866%). Her SAC score increased to 30 out of 30 (36.6667%). Stability scores improved, with the average stability score of 66.891% (+48.4146%)
Conclusion: The authors suggest further investigation into multi-modal, intensive approaches to decrease symptom severity, improve SAC scores, and increase stability scores in patients with PCS.
Acknowledgements
The authors would like to thank and acknowledge the contribution of the clinical team at Plasticity Brain Centers,as well as the administrative support team. The authors would also like to thank the Carrick Institute for providing the education utilized to create the multi-modal treatments implemented in this case study.
References
1. Carrick FR, Clark JF, Pagnacco G, Antonucci MM, Hankir A, Zaman R and Oggero E (2017) Head–Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients. Front. Neurol. 8:414. doi: 10.3389/fneur.2017.00414
2. Gdowski GT, McCrea RA. Integration of vestibular and head movement signals in the vestibular nuclei during whole-body rotation. J Neurophysiol (1999) 82:436–49
3. Pagnacco G, Carrick FR, Wright CH, Oggero E. In-situ verification of accuracy, percision and resolution of force and balance platforms. Biomed Sciences instrumentation (2014) 50:171-8
4. Simon M, Maerlender A, Metzger K, Decoster L, Hollingworth A, McLeod TV. Reliability and Concurrent Validity of Select C3 Logix Test Components. Developmental Neuropsychology (2017) Oct; 0: 1-14. Doi: 10.1080/87565641.2017.1383994. Epub 2017 Oct 25.
Keywords:
Post-concussive syndrome,
Post-Concussion Syndrome,
concussion rehabilitation,
Neurorehabilitation,
Vestibular Rehabilitation,
chiropractic neurology,
Functional Neurology,
brain rehabilitation
Conference:
International Symposium on Clinical Neuroscience 2018, Orlando, Florida, United States, 24 May - 26 May, 2018.
Presentation Type:
Poster
Topic:
Clinical Applications in health, disease, and injury to the nervous system
Citation:
Klotzek
A,
Kalambaheti
ER,
Antonucci
MM and
Manno
M
(2018). Improvements in Cognition and Stability Scores Following Neurological Rehabilitation for a 68-year-old Female Patient with Post-Concussive Syndrome.
Front. Neurol.
Conference Abstract:
International Symposium on Clinical Neuroscience 2018.
doi: 10.3389/conf.fneur.2018.60.00067
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Received:
31 Mar 2018;
Published Online:
14 Dec 2018.
*
Correspondence:
Dr. Emily R Kalambaheti, Plasticity Brain Centers, Orlando, United States, Emily.Kalambaheti@gmail.com