Concussion treatment met with both delight, skepticism

Some concussion sufferers say achiropractic treatment called vestibular therapy has given them back their lives, but some doctors and neuroscientists are urging caution.

Ottawa chiropractor Joseph Lawrence practises vestibular therapyout of the BroadviewSpine & Health Centre. The therapy is based on the methods of Dr. Ted Carrick, a Canadian-born specialist in chiropractic neurology who has treated NHL hockey player Sidney Crosby.

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Also known asfunctional neurology, vestibular therapyinvolvesa series of eye exercises, balance work, lifestyle changesand diagnostic testing designed tostrengthen and re-activate parts of the brain.

It's based on the concept of "neuroplasticity" the idea that the brain can be re-trainedor re-wired after an injury.

Kate Darch, one of Lawrence's patients, got a concussion when she headed a soccer ball during agame.

"A bad day would be in bed, in the dark, all day. Words weren't coming to my head and I was very frustrated. I'm usually a very bubbly person," she said.

Darchfirst visited her doctor, then a physiotherapist, then an eye specialist, who all told her recovery wasgoing to take time and to wait it out, she said. But her symptoms persisted for more than a year, and then a colleague mentioned Lawrence's work.

After nine weeks of treatment at hisclinic, Darchsaid she feels better.

"It's not just me noticing a difference, it's everybody around me noticing a difference. So it's absolutely life-changing," she said.

But vestibular therapyisn't yet scientifically proven, and some medical professionals have expressed concernsabout its use.

Dr. Franois Tremblay, a rehabilitation sciences professor at the University of Ottawa's faculty of medicine and a senior investigator at Bruyere Research Institute, said more research is needed.

"So far the science is not really there. At this moment we don't know exactly what is the best approach for post-concussion syndromewith persisting symptoms, so we don't have very clear answers," he said.

Dr. Kristian Goulet, the directorof CHEO's concussion clinic, urgedcaution because of the time the treatmenttakes, the cost Lawrence charges $475 forinitial exams and then $185 per half-hour sessionand because not enough research has been done to prove the method'seffectiveness.

"We all need to be held to a high standard. Whether you're a medical doctor or physiotherapist or any allied health professional,we have to let science do the talking. And that's why we have clinics, that's why we have this CHEO clinic, to try to do research. We owe it to our patients to only practise things that have been shown [to work]."

Dr. Charles Tator, a professor of neurosurgery at the University of Toronto and a concussion expert who testified at the inquest into the death of Ottawa rugby player Rowan Stringer, said chiropractors may have a roleto play in concussion recoveryif the injury included whiplash, for example but that patients should also beseen by a doctor.

Lawrence acknowledged the method is relatively new and thatmoreresearch and clinical trials are needed, but said his focus is on getting results with patientsrather than convincing sceptics.

"The individuals that get help is really what our main focus is," he said.

The College of Chiropractors of Ontario said there are no specific rules restricting chiropractors from treating concussions, as long as the treatment falls within the "chiropractic scope of practice."

The college also said it advises its members to work with medical doctors, who have the ability toorder MRIs or CT scans, as an example.

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