Grant: Team Grant: External Insults to the Nervous System

Traumatic brain injuries (TBI) are among the most commonly occurring injuries internationally. Dizziness and difficulty with balance and vision may occur following a TBI. Many people recovery in the initial weeks following injury but in some cases symptoms and difficulty functioning continues and may require treatment. There is little research evaluating the effects of treatment in this area. There is some research that balance and vision treatment may help with recovery after a TBI. Thus, the aim of this research program is to bring together an international group with knowledge in TBI of all types and: 1) Evaluate potential problems with vision, inner ear-eye reflexes and deficits of processing eye information that occur following TBI; and 2) Evaluate treatment programs for individuals with eye and inner ear problems that persist for greater than 10 days following injury. This study will include 465 youth and young adults (aged 6-30) who sustain a TBI of any severity. An initial evaluative phase using the best available technology to evaluate eye and inner ear function will be performed and compared with typical tests that are used in the clinic. If symptoms and functional alterations remain 10 days after injury, participants will be randomly placed into a treatment group (including eye movement, inner ear-eye reflex and attention exercises as per our pilot studies) or a control group (typical rehabilitation). The main outcomes of interest are return to sport (mild TBI), goal attainment (moderate and severe TBI) and quality of life (PedsQL). It is expected that this program will inform clinical practice and future research leading to a treatment program in TBI that includes multiple components of treatment. Ultimately, this program will lead to better health care delivery and decreased public health burden from TBI.