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.
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
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.
Parallel
Vestibular Rehabilitation Program
Other interventionParticipants 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.
Conventional Post-Concussion Rehabilitation
Other interventionParticipants 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.
Gait Performance Assessed Using the Timed Tandem Gait (TTG) Test
Change in gait performance measured by the Timed Tandem Gait (TTG) Test. The outcome will be reported as the average time (seconds) required to complete the test. Lower completion time indicates better gait performance.
Balance Performance Assessed Using the Balance Error Scoring System (BESS)
Change in balance performance measured using the Balance Error Scoring System (BESS). The outcome will be reported as the total number of balance errors during standardized balance tasks. Lower scores indicate better balance performance.
Post-Concussion Symptom Severity Assessed Using the Sport Concussion Office Assessment Tool 6 (SCOAT6) Symptom Scale
Change in post-concussion symptom severity measured using the symptom scale component of the Sport Concussion Office Assessment Tool 6 (SCOAT6). The symptom scale includes 22 symptoms, each rated from 0 (none) to 6 (severe), resulting in a total score ranging from 0 to 132. Higher scores indicate greater post-concussion symptom severity.
Concussion Severity Classification Assessed Using the Cantu Concussion Grading Scale
Concussion severity will be assessed using the Cantu Concussion Grading Scale, which classifies concussion into Grade 1 (mild), Grade 2 (moderate), and Grade 3 (severe). The scale ranges from Grade 1 to Grade 3, with higher grades indicating greater concussion severity. Participants will be assessed at baseline for study characterization and eligibility.
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