Effect of Vestibular Rehabilitation on Gait, Balance, and Coordination in Post Concussion Combat Athletes

This randomized controlled trial aims to investigate the effect of vestibular rehabilitation on gait and balance in post-concussion combat athletes. Combat sport athletes, including those participating in boxing, mixed martial arts (MMA), taekwondo, judo, and similar disciplines, are at a heightened risk of sustaining concussions due to repetitive head impacts, rapid directional changes, and falls inherent to their sports. Although most athletes recover within a few weeks, a substantial proportion continue to experience persistent vestibular symptoms such as dizziness, postural instability, impaired gait, and balance deficits, which may adversely affect athletic performance, delay return to sport, and increase the risk of recurrent injury.

Despite growing evidence supporting vestibular rehabilitation in the general post-concussion population, there remains a paucity of sport-specific research focusing on combat athletes, whose functional demands and rehabilitation requirements differ considerably from those of non-athletic populations.

This study will recruit combat athletes aged 18-25 years with at least two years of training experience who have been diagnosed with mild traumatic brain injury within the previous six months and continue to exhibit post-concussion symptoms affecting gait and balance. Eligible participants who have been medically cleared by a physician or neurologist will undergo baseline assessments using the Cantu Concussion Grading Scale and the Sport Concussion Office Assessment Tool 6 (SCOAT6), followed by standardized evaluations of gait and balance.

Participants will then be randomly allocated to either the vestibular rehabilitation group or the control group. The intervention group will receive a structured vestibular rehabilitation program designed to improve vestibulo-ocular function, gaze stabilization, postural control, and balance, while the control group will receive conventional rehabilitation. Outcome measures will be reassessed at Week 8 using the same standardized assessment procedures to determine the effectiveness of the intervention.

It is hypothesized that vestibular rehabilitation will result in significant improvements in gait performance, balance, and post-concussion symptom severity among post-concussion combat athletes.

The findings of this study are expected to provide evidence for the development of targeted, sport-specific rehabilitation protocols, facilitate safer and more efficient return-to-play decisions, reduce the risk of recurrent injury, and contribute to the advancement of concussion management strategies in sports physiotherapy and neurorehabilitation.

Inclusion criteria

• Participants falling in this category would be recruited into the study.
• Age 18-30 years.
• Combat sport athletes (e.g, boxing, MMA, karate) with at least 2 years of training experience.
• Experiencing post-concussion symptoms affecting gait, balance, or coordination
• Willing and able to provide informed consent

Exclusion criteria

• Participants fall in this category would be excluded of the study.
• History of moderate to severe TBI or repeated concussions (>3 cantu scale)
• Preexisting vestibular or neurological disorders unrelated to concussion (e.g., Meniere's disease, multiple sclerosis).
• Current musculoskeletal injuries affecting gait or balance.
• Visual or auditory impairments that interfere with assessments.
• Use of medications that influence balance or coordination (e.g., sedatives, muscle relaxants).
• Unwillingness or inability to participate in the full duration of the rehabilitation protocol.