Mild Traumatic Brain Injury

Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial

By Frank M. Painter|September 7, 2025|Mild Traumatic Brain Injury, Pediatrics|

Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young
Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial

SOURCE: J Manipulative Physiol Ther 2024 (Jan); 47 (1-4): 1–11

Alice E. Cade PhD • Philip R.K. Turnbull PhD

Department Optometry & Vision Science,
University of Auckland, Auckland, New Zealand;
Centre for Chiropractic Research,
New Zealand College of Chiropractic,
Auckland, New Zealand.

Objective: This study aimed to establish if chiropractic care can improve oculomotor and cognitive symptoms in individuals with persistent postconcussion syndrome (PPCS).

Methods: A single-blind, randomized controlled intervention study recorded baseline computerized eye-tracker assessment (CEA) outcomes in 40 young adults with PPCS following mild traumatic brain injury. Participants were randomly allocated to either a chiropractic or age-matched active control intervention, and the change in CEA outcomes following intervention was compared between the chiropractic and control groups. A battery of CEAs including egocentric localization, fixation stability, pursuit, saccades, Stroop, and the vestibulo-ocular reflex, were used to assess oculomotor function, visual attention/processing, and selective attention.

Results: Relative to the control group, participants receiving the chiropractic intervention scored better in the Stroop test (P < .001), had improved gaze stability during both vestibulo-ocular reflex (P < .001) and fixation stability (P = .009), and a lower vertical error in egocentric localization (P < .001). However, performance was poorer in pursuits, where they had an increased tracking error (P < .001).

Conclusion: Chiropractic care in participants with PPCS significantly improved static and dynamic gaze stability, and performance in the Stroop test, compared with a control intervention. These results suggest that chiropractic care can offer a novel avenue for alleviating certain visual and cognitive symptoms in patients with PPCS. It also adds to the growing evidence that suggests that some longstanding PPCS visual symptoms may have a spinal or proprioceptive basis.

Keywords: Brain Concussion; Chiropractic; Eye-Tracking Technology; Postconcussion Syndrome; Proprioception.

From the Full-Text Article:

Introduction

Traumatic brain injury (TBI) is a change in typical brain function that affects neurologic function after an external force to the head. [1, 2] Diagnosis and categorization of TBI severity is currently subjective, open to bias, and predicting an individual’s outcome after injury is challenging. [3, 4] Although symptoms can vary depending on the neurologic area of injury, visual symptoms are common following even mild TBI (MTBI) owing to the many areas of the brain involved in processing vision [5] and controlling the eyes. Visual symptoms can include oculomotor dysfunction including disorders of convergence and accommodation, poorer fixation, slower or less accurate saccades, poorer pursuit movements, and modification of the vestibulo-ocular reflex (VOR). [6]

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Systematic Review of Self-Reported Prognosis

By Frank M. Painter|July 21, 2017|Chiropractic Management, Mild Traumatic Brain Injury|

Systematic Review of Self-Reported Prognosis in Adults After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis

The Chiro.Org Blog

Arch Phys Med Rehabil. 2014 (Mar); 95 (3 Suppl): S132–151

J. David Cassidy, PhD, DrMedSc, Carol Cancelliere, DC, MPH,
Linda J. Carroll, PhD, Pierre Côté, DC, PhD,
Cesar A. Hincapié, DC, MHSc, Lena W. Holm, et al.

Institute of Sports Science and Clinical Biomechanics,
Faculty of Health, University of Southern Denmark,
Odense, Denmark

OBJECTIVE: To update the mild traumatic brain injury (MTBI) prognosis review published by the World Health Organization Task Force in 2004.

DATA SOURCES: MEDLINE, PsycINFO, Embase, CINAHL, and SPORTDiscus were searched from 2001 to 2012. We included published, peer-reviewed studies with more than 30 adult cases.

STUDY SELECTION: Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess subjective, self-reported outcomes. After 77,914 titles and abstracts were screened, 299 articles were eligible and reviewed for scientific quality. This includes 3 original International Collaboration on MTBI Prognosis (ICoMP) research studies.

DATA EXTRACTION: Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed each study and tabled data from accepted articles. A third reviewer was consulted for disagreements.

DATA SYNTHESIS: Evidence from accepted studies was synthesized qualitatively into key findings, and prognostic information was prioritized according to design as exploratory or confirmatory. Of 299 reviewed studies, 101 (34%) were accepted and form our evidence base of prognostic studies. Of these, 23 addressed self-reported outcomes in adults, including 2 of the 3 original ICoMP research studies. These studies show that common postconcussion symptoms are not specific to MTBI/concussion and occur after other injuries as well. Poor recovery after MTBI is associated with poorer premorbid mental and physical health status and with more injury-related stress. Most recover over 1 year, but persistent symptoms are more likely in those with more acute symptoms and more emotional stress.

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Sport Concussion Knowledge and Clinical Practices

By Frank M. Painter|July 19, 2017|Concussion, Mild Traumatic Brain Injury|

Sport Concussion Knowledge and Clinical Practices: A Survey of Doctors of Chiropractic With Sports Certification

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2015 (Sep); 14 (3): 169–175

William J. Moreau, DC, DACBSP, CSCS,
Dustin C. Nabhan, DC, DACBSP, CSCS, RMSK,
Taylor Walden, BA

Managing Director,
United States Olympic Committee,
Colorado Springs, CO

OBJECTIVE: The purpose of this study is to describe the knowledge base and clinical practices regarding concussion by sports-certified doctors of chiropractic.

METHODS: A 21–item survey was distributed to the 312 attendees of the 2014 American Chiropractic Board of Sports Physicians Sports Sciences Symposium. Results were measured by frequency analysis and descriptive statistics for all surveys completed by sports-certified chiropractors.

RESULTS: Seventy-six surveys were returned by sports-certified doctors of chiropractic. All (N = 76) 100% of respondents believe that the evaluation of concussion should be performed by a health care provider with training in concussion. The respondents actively assess and manage concussion in adults (96%), adolescents (95%), and children (75%). A majority (79%) of respondents believe that the Sideline Concussion Assessment Tool–3 represents a current standard of care for the sideline evaluation of the athlete who possibly has sustained a sport concussion. Most respondents agreed or strongly agreed that manual therapies may be appropriate in certain circumstances in adults (80%) and minors (80%).

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