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MedRisk’s ISAB Creates Guidelines for Treating Concussion Symptoms

Approximately 3.8 million Americans have concussions every year, according to the Centers for Disease Control.

While awareness of concussions has grown significantly during the past two decades, not many people realize that physical therapy–specifically vestibular rehabilitation–plays a role in managing post-concussion symptoms.

MedRisk’s International Scientific Advisory Board has created the first vestibular therapy guidelines for treating injured workers suffering from post-concussion symptoms as dizziness, disequilibrium, and/or spatial disorientation. The vestibular system encompasses parts of the inner ear and brain that help control balance and eye movement.

“ISAB determined that vestibular rehabilitation is appropriate for patients whose persistent, post-concussion symptoms involve a measurable, functional deficit in balance or gait,” said Mary O’Donoghue, MedRisk’s Chief Clinical and Product Officer. “Provided by a physical therapist, vestibular rehabilitation is an exercise-based program that improves balance and reduces problems related to dizziness, leg strength and flexibility.”

Based on a review of the most current evidence and expert consensus, MedRisk’s vestibular therapy guidelines provide visit recommendations for non-complicated cases, which are defined as those that have no additional musculoskeletal issues, comorbidities or injuries that require surgery. The guidelines also provide separate recommendations for complicated cases.

“There’s not a lot of research out there that is specific to the treatment of concussions for injured workers,” said Brian Peers, MedRisk’s Director of Clinical Services. “We’ll be monitoring cases closely and revisiting these guidelines and any new evidence again at the next meeting with our advisory board.”

ISAB is an elite panel of world-renowned specialists in physical medicine and workers’ compensation who oversee all clinical aspects of MedRisk’s medical management programs, including the development and maintenance of its proprietary evidence-based guidelines. The group meets regularly to review current scientific literature and new treatment protocols and vet MedRisk’s guidelines, which are specific to physical therapy and workers’ compensation.

Led by Philip McClure, PT, PhD, FAPTA, MedRisk’s ISAB’s members are Paul Beattie, PT, PhD, OCS, FAPTA; Rob de Bie, PT, PhD; David Deitz, MD, PhD; Jane Fedorczyk, PT, PhD, CHT, ATC; William G. Gaines, Jr., MD, MPH; Chris Main, MA, MPhil, PhD, CPsychol; FPBsP; Lori Michener, PT, PhD, ATC, SCS, FAPTA; Marilyn Moffat, PT, DPT, PhD, FAPTA, CSCS, CEEAA; Kathryn Mueller, MD, MPH, FACOEM; Donald Murphy, DC, FRCC; Roger Nelson, PT, PhD, FAPTA; and Matthew Walsworth, MD, PT.

MedRisk has also produced a patient education sheet to help injured workers prepare for vestibular therapy. It can be downloaded at

About MedRisk

Based in King of Prussia, Pennsylvania, MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers. One of the Inc. 5,000 fastest growing privately held companies for 13 consecutive years, MedRisk counts over 117,000 providers in its network and serves almost 500,000 injured workers every year. It holds direct contracts with more than 80 percent of the nation’s top workers’ compensation insurers and third-party administrators. MedRisk, which has successfully completed a SSAE 16 Type II examination, ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates and physical therapists are based in the U.S. For more information, visit or call 800-225-9675.