Cervical spine proprioception and vestibular/oculomotor function: An observational study comparing young adults with and without a concussion history

Objective: To investigate dizziness, vestibular/oculomotor symptoms, and cervical spine proprioception among adults with/without a concussion history. Methods: Adults ages 18-40 years with/without a concussion history completed: dizziness handicap inventory (DHI), visio-vestibular exam (VVE), and head repositioning accuracy (HRA, assesses cervical spine proprioception). Linear regression models were used to assess relationships between (1) concussion/no concussion history group and VVE, HRA, and DHI, and (2) DHI with HRA and VVE for the concussion history group. Results: We enrolled 42 participants with concussion history (age = 26.5 +/- 4.5 years, 79% female, mean = 1.4 +/- 0.8 years post-concussion) and 46 without (age = 27.0 +/- 3.8 years, 74% female). Concussion history was associated with worse HRA (8 = 1.23, 95% confidence interval [CI]: 0.77, 1.68; p < 0.001), more positive VVE subtests (beta = 3.01, 95%CI: 2.32, 3.70; p < 0.001), and higher DHI scores (beta = 9.79, 95%CI: 6.27, 13.32; p < 0.001) after covariate adjustment. For the concussion history group, number of positive VVE subtests was significantly associated with DHI score (beta = 3.78, 95%CI: 2.30, 5.26; p < 0.001) after covariate adjustment, while HRA error was not (beta = 1.10, 95%CI: -2.32, 4.51; p = 0.52). Conclusions: Vestibular/oculomotor symptom provocation and cervical spine proprioception impairments may persist chronically (i.e., 3 years) after concussion. Assessing dizziness, vestibular/oculomotor and cervical spine function after concussion may inform patient-specific treatments to address ongoing dysfunction.