Concussion treatment met with both delight, skepticism

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

Ottawa chiropractor Joseph Lawrence practises vestibular therapy out of the Broadview Spine & 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 as functional neurology, vestibular therapy involves a series of eye exercises, balance work, lifestyle changes and diagnostic testing designed to strengthen and re-activate parts of the brain.

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

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

"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.

Darch first visited her doctor, then a physiotherapist, then an eye specialist, who all told her recovery was going 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 his clinic, Darch said 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 therapy isn't yet scientifically proven, and some medical professionals have expressed concerns about its use.

Dr. François 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 syndrome with persisting symptoms, so we don't have very clear answers," he said.

Dr. Kristian Goulet, the director of CHEO's concussion clinic, urged caution because of the time the treatment takes, the cost — Lawrence charges $475 for initial exams and then $185 per half-hour session — and because not enough research has been done to prove the method's effectiveness.

"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 role to play in concussion recovery — if the injury included whiplash, for example — but that patients should also be seen by a doctor.

Lawrence acknowledged the method is relatively new and that more research and clinical trials are needed, but said his focus is on getting results with patients rather 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 to order MRIs or CT scans, as an example.

Listen to Hallie Cotnam's radio item below.