Physical Therapy Timing Affects Outcomes After Mild Traumatic Brain Injury
Patients with subacute mild traumatic brain injury (mTBI) who began physical therapy within 1 week of injury had faster and more complete improvement than those who started rehabilitation 6 weeks later, according to study results published in Physical Therapy & Rehabilitation Journal.
“There may be an important window to address central sensorimotor deficits after mTBI,” wrote corresponding author Laurie A. King, PhD, PT, MCR, of Oregon Health & Science University and the Veterans Affairs Portland Health Care System, Portland, Oregon, and study coauthors.
The investigator-blinded, randomized controlled trial focused on 203 adults with mTBI who were not athletes. Among them, 82 were assigned to an “early” group that began rehabilitation within 1 week, and 121 were assigned to a “later” group that began similar rehabilitation after a 6-week wait. Rehabilitation for both groups was administered by licensed physical therapists and lasted 6 weeks.
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At the end of the rehabilitation program, both the early and later groups showed significant gains, attaining similar levels on the Dizziness Handicap Inventory as well as on patient-reported mTBI outcomes. However, improvement was significantly faster and larger in the early group.
Moreover, the early group improved significantly in sensorimotor time delay while the later group showed no change. In motor activation components for balance control, the early group showed no change, the study found, while the later group worsened.
“Earlier physical therapy after mTBI can improve symptoms at a faster rate relative to later physical therapy,” researchers concluded. “Earlier physical therapy also showed improvements in sensorimotor aspects of balance control not seen in the later group.”
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