Evidence map›Paper›PMID 41033748›Full record

Trial reportBritish journal of sports medicine2026

CONCUSS randomised clinical trial of vergence/accommodative therapy for concussion-related symptomatic convergence insufficiency.

Tara L Alvarez, Mitchell Scheiman, Farzin Hajebrahimi, Melissa Noble, Suril Gohel, Rebecca Baro, Josie A Bachman, Christina L Master, Arlene Goodman, CONCUSS Investigator Group

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05262361 (Functional Mechanism of Neural Control in Persistent Post-Concussion Symptoms Convergence Insufficiency), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05262361 nacompletednot on this map

Functional Mechanism of Neural Control in Persistent Post-Concussion Symptoms Convergence Insufficiency

TypeinterventionalSponsorNew Jersey Institute of TechnologyRan2021 to 2026Enrolled112ConditionsPersistent Post-concussive Symptoms, Convergence Insufficiency, Mild Traumatic Brain Injury, Concussion, MildArmsOffice-based Vergence and Accommodative Therapy
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tara L Alvarez *Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA alvarez@njit.edu ms5758@drexel.edu.ORCID http://orcid.org/0000-0002-8797-1613
Mitchell Scheiman *Pennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA alvarez@njit.edu ms5758@drexel.edu.
Farzin HajebrahimiDepartment of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA.
Melissa NobleDepartment of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA.
Suril GohelDepartment of Health Informatics, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA.
Rebecca BaroPennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA.
Josie A BachmanPennsylvania College of Optometry, Drexel University, Philadelphia, Pennsylvania, USA.
Christina L MasterDepartment of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Arlene GoodmanSomerset Pediatric Group, New Jersey Institute of Technology, Newark, New Jersey, USA.
CONCUSS Investigator Group

Funding

Functional Mechanisms of Neural Control in Convergence InsufficiencyR01EY023261 · NEI · NEW JERSEY INSTITUTE OF TECHNOLOGY · PI ALVAREZ, TARA LYNN · 2014 to 2025
$4.9M
NEI NIH HHS R01 EY023261
6 · The paper itself

Abstract

objectiveThe CONCUSS randomised clinical trial compared the effectiveness of immediate office-based vergence/accommodative therapy with movement (OBVAM) to delayed therapy for the treatment of concussion-related convergence insufficiency (CONC-CI) in participants 11-25 years old with persisting postconcussive symptoms 4-24 weeks post injury.

methodsSymptomatic CONC-CI was diagnosed using clinical signs via near point of convergence (NPC) and positive fusional vergence (PFV) and symptoms via the Convergence Insufficiency Symptom Survey (CISS). Participants were randomised to immediate OBVAM (twice weekly for 6 weeks) or delayed OBVAM (starting 6 weeks after baseline enrolment). After 6 weeks (outcome time 1 assessment), the therapeutic outcomes of NPC, PFV and CISS were assessed and compared between the two groups. After the outcome time 1 assessment, the delayed group received twice-weekly OBVAM sessions for 8 weeks, while the immediate group received an additional 2 weeks of twice-weekly OBVAM sessions. The outcome time 2 assessment compared groups after each group received all 16 OBVAM sessions.

resultsIn the immediate group, 46/52 (88%) were classified as successful or improved at the outcome time one assessment based on the primary outcome measure, a composite of NPC and PFV, compared with 4/52 (8%) in the delayed group (p<0.001). The mean NPC decreased (improved) by 7.9 cm in the immediate group and 1.8 cm in the delayed group (mean difference at outcome time 1 assessment: 5.1 cm (95% CI: 3.9 to 6.3; p<0.001)). The mean PFV increased (improved) by 17.5Δ in the immediate group and 2.5∆ in the delayed group (mean difference at outcome time 1 assessment: 15.0∆ (95% CI:11.7 to 18.3); p<0.001). At the outcome time 1 assessment, 41/52 (79%) of the participants in the immediate group had improved symptoms based on CISS scores ≤ preinjury scores or decreased by 10 points or more, compared with only 7/52 (13%) of participants from the delayed group (p<0.001). When comparing dosing in the immediate group, for 12 OBVAM sessions, 88% were classified as successful or improved using the composite measurement of NPC and PFV, which increased to 94% after 16 OBVAM sessions. For the outcome time 2 assessment, when both groups had received 16 OBVAM sessions, no significant difference was observed for NPC, PFV or CISS (p=1.0).

conclusionOBVAM therapy is effective in improving the NPC, PFV and symptoms in CONC-CI. Immediate initiation of OBVAM compared with delayed initiation shortens the period of symptoms experienced and fosters an earlier return to activities. TRIAL REGISTRATION NUMBER: clinicaltrials.gov identifier: NCT05262361.

Indexed as

Brain ConcussionOcular Motility DisordersPost-Concussion SyndromeAccommodation, OcularAdolescentAdultChildConvergence, OcularFemaleHumansMaleTreatment OutcomeYoung AdultBrain ConcussionPhysical Therapy SpecialtyVision, Ocular

Identifiers

PMID41033748
PMCPMC12591301

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.