Dizziness Is Associated With Neck/Shoulder Pain Following Pediatric Concussion. Issue 6 (28th November 2022)

• Record Type: Journal Article
• Authors: Smulligan, Katherine L.; Wingerson, Mathew J.; Seehusen, Corrine N.; Smith, Andrew C.; Walker, Gregory A.; Wilson, Julie C.; Howell, David. R.
• Is Part Of: Clinical journal of sport medicine. Volume 32:Issue 6(2022)
• Page Start: e562
• Page End: e567
• Publication Date: 2022-11-28
• Subjects: mild traumatic brain injury -- rehabilitation -- cervical spine -- evaluation; Sports medicine -- Periodicals; 617.1027
• DOI: 10.1097/JSM.0000000000001054
• Languages: English
• ISSNs: 1050-642X

Abstract

Abstract : Objective: To examine the association between dizziness and neck/shoulder pain after concussion and if differences in postural stability and oculomotor function exist among patients reporting dizziness with or without concurrent neck/shoulder pain. Design: Cross sectional. Setting: Sports medicine clinic. Patients: Pediatric patients ≤14 days post concussion. Interventions: N/A. Outcome Measures: Patients completed the Health and Behavior Inventory (HBI) symptom rating and separately rated neck/shoulder pain (scale 0-3; 0 = no pain). We grouped patients by HBI dizziness rating (0 = not-dizzy; 1-3 = dizzy) and compared neck/shoulder pain ratings between the groups. We then compared oculomotor and postural stability outcomes between dizzy patients with and without neck/shoulder pain. Results: We included 153 patients: dizzy (n = 100; age = 14.6 ± 2.2 years; 48% female) and not-dizzy (n = 53, age = 14.4 ± 3.1 years; 38% female). The dizzy group reported significantly higher neck/shoulder pain (1.4 ± 1.1 vs 0.5 ± 0.9 points, P < 0.001) and total symptom score (25.7 ± 11.2 vs 11.7 ± 9.3 points, P < 0.001) than the not-dizzy group. After adjusting for total symptom score and preinjury anxiety, depression, and migraines, dizziness was associated with higher odds of neck/shoulder pain (odds ratio = 1.9, 95% CI, 1.2-3.0; P = 0.004). No differences were observed between dizzy patients with and without neck/shoulder pain for near point of convergence (10.0 ± 7.5 vs 8.5 ± 6.7 cm, P = 0.43), modified Balance Error Scoring System (8.9 ± 5.5 vs 6.8 ± 4.7 errors, P = 0.09), or tandem gait (single-task: 26.0 ± 12.3 vs 24.2 ± 11.9 seconds, P = 0.56; dual-task: 35.1 ± 14.3 vs 35.6 ± 18.6 seconds, P = 0.90). Conclusions: In concussion patients experiencing dizziness, evaluating neck/shoulder pain may help identify individuals who would benefit from cervical spine rehabilitation. However, other potential causes of dizziness should also be evaluated to facilitate timely recovery.