Adolescents Demonstrate Greater Gait Balance Control Deficits After Concussion Than Young Adults

Howell, David R.; Osternig, Louis R.; Chou, Li-Shan

doi:10.1177/0363546514560994

Cited by 82 publications

(91 citation statements)

References 33 publications

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“…17–19 Further, the more challenging and complex the task, such as cognitive-motor challenges or obstacle avoidance, the greater and more prolonged the postural control deficits. 17–23 These tasks are regulated by diverse supraspinal structures (e.g., supplementary motor area, dorsal and ventral premotor areas, superior parietal lobe, posterior cingulate cortex) which provides some insight into the neurophysiological post-concussion deficits and these tests batteries have identified deficits in postural control have been noted beyond clinical recovery and up to 1 – 2 months post-concussion. 15, 19, 22–27 While these findings are noteworthy for identifying impairments in challenging dynamic tasks following a concussion, they do not address the ability to plan and self-initiate a step during a transitional movement, a task considered more challenging than gait.…”

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confidence: 99%

Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion

Buckley

Oldham

Munkasy

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective The purpose of this study was to investigate anticipatory postural adjustments (APA) during the transitional movement task of gait initiation (GI) in individuals acutely following a concussion. Design Cohort Study. Setting University Research Center. Participants A population based sample of 84 participants divided into two equal groups of acutely post-concussion (CONC) and healthy student athletes. Intervention Participants were tested on two occasions – a pre-injury baseline test and then the CONC group was retested acutely post-concussion and the control group again at a similar time. All participants completed 5 trials of GI on 4 forceplates. Main Outcome Measures The dependent variables were the displacement and velocity of the center of pressure (COP) during the APA phase and initial step kinematics. Comparisons were made with a 2 (Group) × 2 (Time) repeated measures ANOVA. Results There was a significant interaction for COP posterior displacement (P<0.001) and lateral displacement (P<0.001). Posteriorly, post-hoc testing identified a significant reduction in CONC (PRE: 5.7 ± 1.6 cm and POST: 2.6 ± 2.1 cm, P<0.001), but no difference in Control (PRE: 4.0 ± 1.6 cm and POST: 4.0 ± 2.5 cm, P=0.921). Laterally, post-hoc testing identified a significant reduction in CONC (PRE: 5.8 ± 2.1 cm and POST: 3.8 ± 1.8 cm, P<0.001), but no difference in Control (PRE: 5.0 ± 2.5 cm and POST: 5.2 ± 2.4 cm, P=0.485). Conclusions The results of this study suggest difficulty in the planning and execution of GI acutely post-concussion and posterior APA displacement and velocity are highly effective measures of impaired postural control. Finally, the APA phase is linked to the supplementary motor area which suggests a supraspinal contribution to post-concussion impaired postural control.

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confidence: 99%

Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion

Buckley

Oldham

Munkasy

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…The inferences that can be made about how concussion affects self-reported general health and motor control are therefore limited; the trajectory of recovery of the variables tested in this study remain unclear, albeit we can deduce [in conjunction with a number of recently published articles (25,(33)(34)(35)] that any consensus that concussion-induced impairment will resolve within a 7-day period (36) should probably be abandoned. Another limitation of this study is that we cannot identify if any causal relationship between deficits in postural control and the incidence of concussion.…”

Section: Accepted Manuscriptmentioning

confidence: 91%

Quantification of postural control deficits in patients with recent concussion: An inertial-sensor based approach

Doherty

Zhao

Ryan

et al. 2017

Clinical Biomechanics

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Title: Quantification of postural control deficits in patients with recent concussion: an inertial-sensor based approach. Word count:Abstract: 236 Main text: 3667 Authors:Cailbhe Doherty Background: The aim of this study was to quantify postural control ability in a group with concussion compared with a healthy control group.Method: Fifteen concussion patients (4 females, 11 males) and a group of fifteen age-and sex-matched controls were recruited. Participants were tested during the performance of the three stance variants (bilateral, tandem and unilateral stance) of the balance error scoring system standing on a force place, whilst wearing an inertial measurement unit placed at the posterior aspect of the sacrum. Findings:The area of postural sway was computed using the force-plate and the '95% ]) in the bilateral stance position of the balance error scoring system. The sway volume metric also had excellent accuracy in identifying task 'errors' (tandem stance: 95%CI: 85-96%, p < 0.001; unilateral stance: 95%CI: 86-96%, p < 0.001).Interpretation: Individuals with concussion display increased postural sway during bilateral stance. The sway volume that was calculated from the accelerometer data not only differentiated a group with concussion from a healthy control group, but successfully identified when task errors had occurred. This may be of value in the development of a pitchside assessment system for concussion.

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“…Prior studies have used three-dimensional motion capture and force plate systems to objectively evaluate balance control following concussion, detecting deficits lasting from several days to many months after injury [2,6,7]. Widespread use of these systems in a clinical setting, however, is limited due to cost and space constraints for testing.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of postural stability in youth athletes: the relationship between two rating systems

Howell

Shore

Hanson

et al. 2016

The Physician and Sportsmedicine

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Adolescents Demonstrate Greater Gait Balance Control Deficits After Concussion Than Young Adults

Cited by 82 publications

References 33 publications

Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion

Decreased Anticipatory Postural Adjustments During Gait Initiation Acutely Postconcussion

Quantification of postural control deficits in patients with recent concussion: An inertial-sensor based approach

Evaluation of postural stability in youth athletes: the relationship between two rating systems

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