#57 - Vestibular Rehabilitation After Concussion

Today we’re discussing vestibular rehab after concussion to continue the three areas of concussion treatment physical therapists assist with.

At least half of all patients with concussion will experience balance or vestibular issues after a concussion. Patients affected in these areas may display decreased balance, proprioception problems, vision changes, vertigo, or hearing changes. Physical therapists can use the Balance Error Scoring System (BESS) to identify postural stability and control issues and to measure a patient’s recovery.

During the BESS test patients perform the following stances on both firm and foam surfaces:

  • Double leg stance
  • Single leg stance
  • Tandem stance

The goal is for scores to improve as patients begin their rehab program. Physical therapists should record any deviations on a BESS balance test score sheet to track recovery. Here is a list of errors to note:

  • Moving hands off the iliac crests
  • Opening the eyes
  • Stepping, stumbling or falling
  • Abduction or flexion of the hip beyond 30 degrees
  • Lifting the forefoot or heel off the surface
  • Remaining out of the testing position for more than five seconds

Tune in next week to learn how physical therapists help with cervical spine rehab.


Taking care of your brain is a no brainer