Effect of Vestibular Rehabilitation on Gait, Balance, and Coordination in Post Concussion Combat Athletes

Overview

This randomized controlled trial aims to evaluate the effectiveness of vestibular rehabilitation in improving gait and balance among post-concussion combat athletes aged 18-25 years. Eligible participants diagnosed with mild traumatic brain injury and persistent post-concussion symptoms will be randomly assigned to either a vestibular rehabilitation group or a control group receiving conventional rehabilitation. Gait performance, balance, post-concussion symptom severity, and concussion severity will be assessed using the Timed Tandem Gait (TTG) Test, Balance Error Scoring System (BESS), Sport Concussion Office Assessment Tool 6 (SCOAT6), and Cantu Concussion Grading Scale. Outcome measures will be evaluated at baseline and after the 8-week intervention to determine the effectiveness of vestibular rehabilitation in enhancing functional recovery following concussion.

Detailed description

This randomized controlled trial aims to investigate the effect of vestibular rehabilitation on gait and balance in post-concussion combat athletes. Combat sport athletes, including those participating in boxing, mixed martial arts (MMA), taekwondo, judo, and similar disciplines, are at a heightened risk of sustaining concussions due to repetitive head impacts, rapid directional changes, and falls inherent to their sports. Although most athletes recover within a few weeks, a substantial proportion continue to experience persistent vestibular symptoms such as dizziness, postural instability, impaired gait, and balance deficits, which may adversely affect athletic performance, delay return to sport, and increase the risk of recurrent injury.

Despite growing evidence supporting vestibular rehabilitation in the general post-concussion population, there remains a paucity of sport-specific research focusing on combat athletes, whose functional demands and rehabilitation requirements differ considerably from those of non-athletic populations.

This study will recruit combat athletes aged 18-25 years with at least two years of training experience who have been diagnosed with mild traumatic brain injury within the previous six months and continue to exhibit post-concussion symptoms affecting gait and balance. Eligible participants who have been medically cleared by a physician or neurologist will undergo baseline assessments using the Cantu Concussion Grading Scale and the Sport Concussion Office Assessment Tool 6 (SCOAT6), followed by standardized evaluations of gait and balance.

Participants will then be randomly allocated to either the vestibular rehabilitation group or the control group. The intervention group will receive a structured vestibular rehabilitation program designed to improve vestibulo-ocular function, gaze stabilization, postural control, and balance, while the control group will receive conventional rehabilitation. Outcome measures will be reassessed at Week 8 using the same standardized assessment procedures to determine the effectiveness of the intervention.

It is hypothesized that vestibular rehabilitation will result in significant improvements in gait performance, balance, and post-concussion symptom severity among post-concussion combat athletes.

The findings of this study are expected to provide evidence for the development of targeted, sport-specific rehabilitation protocols, facilitate safer and more efficient return-to-play decisions, reduce the risk of recurrent injury, and contribute to the advancement of concussion management strategies in sports physiotherapy and neurorehabilitation.

Interventions

• Other Vestibular Rehabilitation Program
  Participants will receive a structured vestibular rehabilitation program consisting of vestibulo-ocular reflex (VOR) exercises, gaze stabilization exercises, habituation exercises, balance retraining, postural control exercises, and gait training. The intervention will be supervised by a physiotherapist and delivered over 8 weeks according to the study protocol.
• Other Conventional Post-Concussion Rehabilitation
  Participants will receive conventional post-concussion rehabilitation consisting of education regarding symptom management, symptom-limited activity, graded aerobic exercise, strengthening and conditioning exercises, sport-specific training, and a staged return-to-play progression over 8 weeks. Targeted vestibular rehabilitation exercises will not be included.

Primary outcome measures

• Gait Performance Assessed Using the Timed Tandem Gait (TTG) Test [Time frame: Baseline (Week 0) and Week 8 (post-intervention)]
• Balance Performance Assessed Using the Balance Error Scoring System (BESS) [Time frame: Baseline (Week 0) and Week 8 (post-intervention)]

Secondary outcome measures (2)

• Post-Concussion Symptom Severity Assessed Using the Sport Concussion Office Assessment Tool 6 (SCOAT6) Symptom Scale [Time frame: Baseline (Week 0) and Week 8 (post-intervention)]
• Concussion Severity Classification Assessed Using the Cantu Concussion Grading Scale [Time frame: Baseline (Week 0)]

Eligibility criteria

Inclusion criteria

• Participants falling in this category would be recruited into the study.
• Age 18-30 years.
• Combat sport athletes (e.g, boxing, MMA, karate) with at least 2 years of training experience.
• Experiencing post-concussion symptoms affecting gait, balance, or coordination
• Willing and able to provide informed consent

Exclusion criteria

• Participants fall in this category would be excluded of the study.
• History of moderate to severe TBI or repeated concussions (>3 cantu scale)
• Preexisting vestibular or neurological disorders unrelated to concussion (e.g., Meniere's disease, multiple sclerosis).
• Current musculoskeletal injuries affecting gait or balance.
• Visual or auditory impairments that interfere with assessments.
• Use of medications that influence balance or coordination (e.g., sedatives, muscle relaxants).
• Unwillingness or inability to participate in the full duration of the rehabilitation protocol.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 1 center

• Peshawar Sports Complex — Peshawar

Identifiers

NCT: NCT07717528 · Nigah e Zahra Syed

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗