Targeted Cervicovestibular Rehabilitation for Persistent Symptoms After Sport-Related Concussion: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.70.74643Keywords
sport-related concussion, persistent post-concussion symptoms, cervical spine dysfunction, vestibulo-ocular dysfunction, vestibular rehabilitation, cervicovestibular rehabilitation, return-to-play, oculomotor dysfunction, dizziness, neck painAbstract
Background: Sport-related concussion (SRC) usually resolves within the expected window, but a subgroup of athletes develops persistent symptoms that delay return-to-play (RTP), possibly reflecting overlapping cervical, vestibular, and vestibulo-ocular contributors rather than one post-concussion syndrome.
Aim: To synthesize evidence on cervical, vestibular, and vestibulo-ocular dysfunction after SRC, with emphasis on persistent symptoms, targeted rehabilitation, and RTP.
Material and methods: A structured PubMed search identified literature on SRC, persistent symptoms, cervical and vestibulo-ocular dysfunction, and rehabilitation. Full texts were narratively stratified; no pooling or risk-of-bias assessment was performed.
Results: Cervical, vestibular, and vestibulo-ocular findings are clinically relevant in athletes with delayed recovery and are associated with persistent symptoms in observational studies. One small randomized trial supports combined cervical-vestibular physiotherapy in youth with persistent dizziness, neck pain, or headache; retrospective data suggest earlier vestibular therapy may shorten recovery, though causality remains unproven.
Conclusions: Persistent symptoms after SRC warrant structured reassessment of cervical, vestibular, vestibulo-ocular, balance, and exertional domains. Targeted cervicovestibular rehabilitation appears promising; prospective trials are needed to define referral criteria, timing, sequencing, and RTP criteria.
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