Efficacy of Brock String Therapy Post Concussion

Receded near point of convergence (NPC) is a common oculomotor deficit associated with numerous vision diagnoses, including convergence and accommodative insufficiencies, following sport-related concussion (SRC). Researchers have found associations with worse neurocognitive test scores, higher post-concussion symptom burden, and longer recovery among patients with receded NPC relative to concussion patients with normal NPC. Although oculomotor dysfunction may resolve spontaneously or improves with vision therapy exercises in the post-acute phase of recovery, it is unclear if early intervention can improve recovery outcomes. The Brock String is a cost effective and practical vision therapy exercise for congenital convergence insufficiency (CI), and initial research supports effectiveness with SRC patients who have receded NPC in the subacute phase of recovery (e.g., weeks to months post injury). Early vision therapy intervention may be efficacious in improving recovery times and reduce healthcare costs by eliminating later therapies for chronic deficits.

Inclusion criteria

• Athletes who sustained a concussion during organized sport within past 48 hours
• ages 12-20
• at least one NPC measurement >10 centimeters at initial clinic evaluation.

Exclusion criteria

• lack of access to a smart phone to receive text message prompts
• vestibular disorder
• seizure disorder
• history of traumatic brain injury with imaging findings or brain surgery
• history of 3+ concussions\\
• concussion within the past 6 months
• history of developmental or intellectual disability
• history of substance abuse
• Patients will also be excluded from recruitment if the treating clinician feels the potential participant would be unable to tolerate Brock String therapy due to severe symptoms