The leading cause of hospitalization, disability, and death among Canadians occur from unintentional injuries. Of these, concussions are among the most common and can happen during sports and throughout everyday life (1). Concussions are identified as a form of traumatic brain injury which occur from when the brain rapidly moves inside of the skull (2). Ice hockey, rugby and ringette are the sports with the highest proportion of concussions among children and youth aged 5-19 years old, ranging from 27-44% of all injuries that happened while playing these sports (1).

Post-Concussion Syndrome (PCS) is a complex disorder of various ongoing signs and symptoms which persist beyond 1-4 weeks from the initial mechanism of injury (3). The prevalence of PCS can be as high as 50% within one month and 15% within a year of those who sustain a traumatic brain injury (4). It is estimated that 40-60% of those with PCS suffer from some form of dizziness and/or disequilibrium which may be attributed to a vestibular (i.e. inner ear) dysfunction (5). Properly identifying and managing the various components of a concussion should be a top priority for all sporting organizations and healthcare providers to ensure fast and efficient recoveries.

Part of a thorough concussion assessment may involve a Vestibular Ocular Motor Screening (VOMS). This quick and easy test looks at the systems responsible for integrating balance, vision and movement (6). These components include:

• Smooth pursuits
• Saccadic or rapid eye movements
• Near point of convergence
• Vestibular ocular reflex
• Visual motion sensitivity

The VOMS has been shown to be a clinically effective tool, helping to identify issues not found in other assessments (7). This will ensure that those suffering from PCS with a vestibular component can be prescribed the proper exercises, thereby facilitating a quicker recovery.

Here, Ryan Hill is performing a VOMS on a Division 2 Women’s rugby player from the Capilano Rugby Football Club with a suspected post-concussion syndrome. The results of this test will help determine when to start a “Return-to-Play Protocol” and what specific exercises she will need to perform to aid with her recovery.

References:
1. Government of Canada. (2018). Concussion in Sport. Retrieved from https://www.canada.ca/en/public-health/services/diseases/concussion-sign-symptoms/concussion-sport-infographic.html’
2. Centres for Disease Control and Prevention. (2019, February 12). What is a Concussion? Retrieved from https://www.cdc.gov/headsup/basics/concussion_whatis.html
3. Mayo Clinic. (2017, July 28). Post-concussion syndrome. Retrieved from https://www.mayoclinic.org/diseases-conditions/post-concussion-syndrome/symptoms-causes/syc-20353352
4. Legome, E. (2018, September 24). What is the prevalence of postconcussion syndrome (PCS)? Retrieved from https://www.medscape.com/answers/828904-158205/what-is-the-prevalence-of-postconcussion-syndrome-pcs
5. Kolev, O. and Sergeeva, M. (2016, June 30). Vestibular disorders following different types of head and neck trauma. Functional Neurology. 2016 Apr-Jun; 31(2): 75–80. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936800/
6. University of Pittsburgh Medical Centre. (2016). Sports Medicine VOMS Testing. Retrieved from http://rethinkconcussions.upmc.com/2016/10/what-is-voms/
7. Yorke, A., et al. (2016, November 11). Validity and Reliability of the Vestibular/Ocular Motor Screening and Associations With Common Concussion Screening Tools. Sports Health. 2017 Mar-Apr; 9(2): 174–180. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349391/