Effective Physiotherapy for Post-Concussion Recovery and Return to Sports: Narrative Review

Traumatic brain injury (TBI) caused by direct or indirect forces is a prevalent issue in contact sports, leading to symptoms such as headaches, dizziness, nausea, and neck pain. These symptoms can have long-term consequences, including neurodegenerative diseases and mood disorders. This review fills an essential gap in the literature, as current studies on physiotherapy for traumatic brain injury (TBI) in sports are limited in scope, particularly in evaluating multimodal and personalized interventions. The review aims to synthesize and highlight the most effective approaches, providing crucial insights for developing evidence-based best practices. Searches were performed across multiple biomedical databases, including PubMed, Cochrane Library, PEDro, Scopus, and Web of science. The primary outcomes measured were the time taken to return to sports and the reduction of symptoms. Five studies were selected based on inclusion criteria. The search strategy included specific keywords such as ‘brain concussion,’ ‘rehabilitation,’ ‘physiotherapy,’ and ‘return to sport.’ Inclusion criteria targeted randomized controlled trials and systematic reviews on physiotherapeutic interventions in TBI cases. In contrast, exclusion criteria ruled out studies lacking clinical applicability or with non-sport-related populations. The review included 93 initial studies, of which five met the inclusion criteria. Combined spinal and vestibular rehabilitation treatments were found to be more effective than individual treatments. Rest in the acute phase, followed by moderate aerobic activity, was also beneficial. The combined approach facilitated a quicker return to sports, with 73% of participants in the intervention group returning to sports within eight weeks compared to 7% in the control group. Characteristics of the included studies, such as sample sizes (ranging from 10 to 100 subjects), participant demographics (ages 8-72 years), and the statistical significance of findings (p-values ranging from 0.01 to 0.05), were assessed. Limitations included the small sample sizes and intervention heterogeneity, which could introduce bias.” Multimodal and personalized physiotherapeutic interventions are essential for effective rehabilitation in patients with TBI, particularly for a timely return to sports. Despite the positive findings, the current literature is limited and further research is necessary to explore medium and long-term interventions. Additional research is recommended in areas such as the long-term effectiveness of multimodal interventions and their application in diverse populations. Clinical practice implications include integrating personalized treatment plans to enhance recovery outcomes.