Background High-technology methods demonstrate that balance problems may persist up to 30 days after a concussion, whereas with low-technology methods such as the Balance Error Scoring System (BESS), performance becomes normal after only 3 days based on previously published studies in collegiate and high school athletes. Purpose To compare the National Institutes of Health’s Balance Accelerometer Measure (BAM) with the BESS regarding the ability to detect differences in postural sway between adolescents with sports concussions and age-matched controls. Study Design Cohort study (diagnosis); Level of evidence, 2. Methods Forty-three patients with concussions and 27 control participants were tested with the standard BAM protocol, while sway was quantified using the normalized path length (mG/s) of pelvic accelerations in the anterior-posterior direction. The BESS was scored by experts using video recordings. Results The BAM was not able to discriminate between healthy and concussed adolescents, whereas the BESS, especially the tandem stance conditions, was good at discriminating between healthy and concussed adolescents. A total BESS score of 21 or more errors optimally identified patients in the acute concussion group versus healthy participants at 60% sensitivity and 82% specificity. Conclusion The BAM is not as effective as the BESS in identifying abnormal postural control in adolescents with sports concussions. The BESS, a simple and economical method of assessing postural control, was effective in discriminating between young adults with acute concussions and young healthy people, suggesting that the test has value in the assessment of acute concussions.

The DGI and the FGA are responsive to change over time in persons with balance and vestibular disorders. More complex gait measures need to be developed, as close to 50% of the subjects received optimal scores at discharge from a physical therapy exercise program, indicating that these measures have a ceiling effect.

Studies suggest that aging affects the sensory re-weighting process, but the neuroimaging evidence is minimal. Functional Near-Infrared Spectroscopy (fNIRS) is a novel neuroimaging tool that can detect brain activities during dynamic movement condition. In this study, fNIRS was used to investigate the hemodynamic changes in the frontal-lateral, temporal-parietal, and occipital regions of interest (ROIs) during four sensory integration conditions that manipulated visual and somatosensory feedback in 15 middle-aged and 15 older adults. The results showed that the temporal-parietal ROI was activated more when somatosensory and visual information were absent in both groups, which indicated the sole use of vestibular input for maintaining balance. While both older adults and middle-aged adults had greater activity in most brain ROIs during changes in the sensory conditions, the older adults had greater increases in the occipital ROI and frontal–lateral ROIs. These findings suggest a cortical component to sensory re-weighting that is more distributed and requires greater attention in older adults.

In this study, functional near-infrared spectroscopy (fNIRS) was used to record brain activation during cognitive testing in older individuals (88±6yo; N = 19) living in residential care communities. This population, which is often associated with loss of personal independence due to physical or cognitive decline associated with aging, is also often under-represented in neuroscience research because of a limited means to participate in studies which often take place in large urban or university centers. In this study, we demonstrate the feasibility and initial results using a portable 8-source by 4-detector fNIRS system to measure brain activity from participants within residential care community centers. Using fNIRS, brain signals were recorded during a series of computerized cognitive tests, including a Symbol Digit Coding test (SDC), Stroop Test (ST), and Shifting Attention Test (SAT). The SDC and SAT elicited greater activity in the left middle frontal region of interest. Three components of the ST produced increases in the right middle frontal and superior frontal, and left superior frontal regions. An association between advanced age and increased activation in the right middle frontal region was observed during the incongruent ST. Although none of the participants had clinical dementia based on the short portable mental status questionnaire, the group performance was slightly below age-normed values on these cognitive tests. These results demonstrate the capability for obtaining functional neuroimaging measures in residential settings, which ultimately may aid in prognosis and care related to dementia in older adults.

The International Classifi cation of Functioning, Disability, and Health (ICF) provides a comprehensive framework for classifying function. Among the mobility activities of the ICF are those that require the maintaining and changing body position, which in turn depend on static and dynamic stability (balance). This review describes subjective and objective methods that can be used within the laboratory and clinic to quantify static and dynamic balance. There are numerous valid and reliable measures now available to clinicians that quantify static and dynamic balance.T he International Classifi cation of Functioning, Disability, and Health (ICF) is a classifi cation system that encompasses the context of human health and health-related domains .1 In the ICF framework, mobility is classifi ed as an activity that includes "changing and maintaining body position." Clinicians working with older adults need measurements by which postural stability while changing and maintaining body position can be quantifi ed. The purpose of this article is to review measures commonly used to quantify static and dynamic balance and to discuss alternatives for quantifying postural stability while "changing and maintaining body position." Common laboratory measures will be discussed fi rst. LABORATORY MEASURESLaboratory equipment is usually expensive and requires space. However, laboratory equipment typically provides greater accuracy and objectivity for quantifying stability during the maintenance and alteration of body positions. The most commonly used laboratory equipment includes force plates, motion analysis systems, and computerized dynamic posturography. Force platesForce plates integrate multiple force transducers to quantify postural control via mathematical calculation of the excursion of the center of pressure (COP) from ground reaction forces. 2 During quiet standing, one needs to maintain the body's center of mass (COM) within the base of support. However, it does not mean that COP and COM move in the same manner. Horak and Nashner 3 proposed an inverted pendulum model of balance. Horak and Nashner's model demonstrated different movement patterns of COP and COM while standing quietly on a force plate. Dynamic balance, which is required for gait, is a more complex condition. To ambulate, the COM is sometimes outside the base of support and the COP needs to shift between the lower extremities. 2 The quantifi cation of dynamic balance usually combines a motion analysis system and force plates because of the complexity of the movement.Several variables can be derived from the excursions of the COP, such as the root mean square of COP amplitudes in the anteroposterior and mediolateral direction, the path length of COP, the maximum COP displacement in the anteroposterior and mediolateral direction and the mean velocity of COP. 4 The root mean square of COP is the most common calculation used in related topic articles. [5][6][7] The reliability of force plate measures under various conditions has been shown to be good to excellent...

No abstract

No abstract

No abstract