Visio-Vestibular Rehabilitation Pathways Post-Concussion In Contact Sports: A Focus On Kabaddi

Abstract

Background: Kabaddi is a high-intensity contact sport that comes from the Indian subcontinent. It is now recognized worldwide and is played at both international and Olympic-qualifying levels. The sport’s physical demands involve full-body tackling, raiding, and defensive grappling, which put athletes at significant risk of sport-related concussion (SRC). While awareness of SRC is growing in established Western sports like rugby and American football, the concussion patterns and rehabilitation processes for Kabaddi players are still not well studied. The visio-vestibular system is often disrupted after an SRC, leading to symptoms such as dizziness, problems with eye movement, sensitivity to visual motion, and instability in posture. These symptoms can make recovery longer and delay the athlete's return to play. Objective :This systematic review brings together current evidence on visio-vestibular rehabilitation (VVR) after a concussion in contact sports. It connects these findings to the specific biomechanical, epidemiological, and clinical context of Kabaddi. We assess the effectiveness of Vestibular Ocular Motor Screening (VOMS), vestibulo-ocular reflex (VOR) exercises, oculomotor retraining, gaze stabilization, and multimodal rehabilitation protocols. Additionally, we suggest a framework for Kabaddi-specific VVR. Methods : We carried out a systematic electronic literature search across several databases, including PubMed, CINAHL, SPORTDiscus, Cochrane, MEDLINE, PEDro, and Web of Science. The search terms included combinations of vestibular rehabilitation, visio-vestibular, oculomotor, concussion, mild traumatic brain injury (mTBI), sport-related concussion, return to play, Kabaddi, contact sports, VOR, gaze stabilization, and VOMS. We followed PRISMA 2020 guidelines for article screening and data extraction. Inclusion criteria required peer-reviewed studies focused on human athletes with SRC who received visio-vestibular interventions, published in English between 2011 and 2026. Results: Twelve primary studies and four systematic reviews met our inclusion criteria. The evidence shows that starting visio-vestibular rehabilitation early—within 10 to 14 days after a concussion—greatly reduces recovery time and helps athletes return to play sooner than resting alone. Athletes who received vestibular rehabilitation were cleared to play up to 1.99 times faster than those in the control group. Untreated vestibulo-ocular dysfunction (VOD) can double recovery time. Multimodal approaches that combine cervical spine treatment, VOR exercises, gaze stabilization, and progressive aerobic reintegration showed the best outcomes. We did not find any studies on concussion rehabilitation specific to Kabaddi, which highlights a critical gap in research. Conclusions :Visio-vestibular rehabilitation is a key part of modern management for concussions in contact sports. Kabaddi athletes have biomechanical and exposure profiles that put them at high risk for SRC, yet they are largely overlooked in sports concussion research. We propose a structured, phased VVR protocol to address Kabaddi's unique demands. Immediate research priorities should focus on prospective studies in Kabaddi, establishing baseline VOMS profiles for elite players, and conducting randomized controlled trials of VVR protocols for this group.