Characterizing Clinical Presentations following Mild Traumatic Brain Injury: Mechanisms of Injury and Dizziness Subtypes

Holte, Kirsten Elizabeth

Characterizing Clinical Presentations following Mild Traumatic Brain Injury: Mechanisms of Injury and Dizziness Subtypes

dc.contributor.advisor	Schneider, Kathryn
dc.contributor.author	Holte, Kirsten Elizabeth
dc.contributor.committeemember	Lun, Victor
dc.contributor.committeemember	Debert, Chantel
dc.contributor.committeemember	Subramaniam, Suresh
dc.date	2024-06
dc.date.accessioned	2024-01-24T19:20:44Z
dc.date.available	2024-01-24T19:20:44Z
dc.date.issued	2024-01-22
dc.description.abstract	This MSc thesis explores clinical presentations following mild Traumatic Brain Injury (mTBI) and includes two studies. The first study evaluates the association between symptom severity score, Vestibular Ocular Motor Screen, vestibulo-ocular reflex (VOR), oculomotor, and cervical spine function and 1) mTBI mechanism and 2) sport type in 98 youth (6-17 years) presenting to acute mTBI clinics (Calgary and Montreal sites). Forty-six males and 55 females sustained a non-sport related concussion (nSRC; n= 18) or sport-related concussion (SRC; n= 80), in contact sport (n=62), or non-contact sport (n=18). No statistically significant differences were found in any outcome by mTBI mechanism. Athletes injured in non-contact sport had a 12.69 (95% CI: 2.38-78.79) times higher odds of abnormal VOR gain compared to those in contact sport. Future research is warranted, including comparison to pre-injury status, to better understand the mechanism driving the differences in VOR by sport type. The second study examines concurrent validity of dizziness subtype classification between a physiotherapist and physician specialist, and test-retest reliability by a physiotherapist in 21 youth and adults diagnosed with SRC. Dizziness subtypes included Benign Paroxysmal Positional Vertigo, Unilateral Peripheral Vestibular Hypofunction, cervicogenic dizziness, centrally mediated dizziness, vestibular migraine, and other. Substantial agreement (k= 0.67, 95% CI 0.35-1.00) was found between the physiotherapist and physician specialist and almost perfect agreement between physiotherapist classifications at the initial and 7-day assessments (k= 1.00, 95% CI 0.56-1.00). At the initial assessment, 71.43% and 35.71% of participants had at least one dizziness subtype categorized as “other” by the physiotherapist and physician specialist, respectively, and multiple dizziness subtypes were selected by both raters for 42.86% of participants. This work will inform the refinement of subtype classification processes, including the addition of potential subtypes to enable further classification. Future research is needed to evaluate a refined version of the subtype classification system in a larger prospective cohort study to further inform dizziness subtype management.
dc.identifier.citation	Holte, K. E. (2024). Characterizing clinical presentations following mild traumatic brain injury: mechanisms of injury and dizziness subtypes (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.uri	https://hdl.handle.net/1880/118052
dc.identifier.uri	https://doi.org/10.11575/PRISM/42896
dc.language.iso	en
dc.publisher.faculty	Graduate Studies
dc.publisher.institution	University of Calgary
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subject	Dizziness
dc.subject	Mild Traumatic Brain Injury
dc.subject	Sport-Related Concussion
dc.subject	Vestibulo-ocular reflex
dc.subject	Cervical spine
dc.subject	Post-traumatic dizziness
dc.subject.classification	Rehabilitation and Therapy
dc.title	Characterizing Clinical Presentations following Mild Traumatic Brain Injury: Mechanisms of Injury and Dizziness Subtypes
dc.type	master thesis
thesis.degree.discipline	Kinesiology
thesis.degree.grantor	University of Calgary
thesis.degree.name	Master of Science (MSc)
ucalgary.thesis.accesssetbystudent	I do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.