Previous Mild Traumatic Brain Injury and Postural-Control Dynamics

Sosnoff, Jacob J.; Broglio, Steven P.; Shin, Sunghoon; Ferrara, Michael S.

doi:10.4085/1062-6050-46.1.85

Cited by 130 publications

(157 citation statements)

References 32 publications

Supporting

Mentioning

135

Contrasting

Unclassified

Order By: Relevance

“…Others, however, have shown changes to neurocognitive functioning, 187,188 brain function, [189][190][191] neuroelectrical activity, [192][193][194][195] and motor control. 196,197 Yet none of these authors reported an association between the declines and clinical impairment. Results of surveys [51][52][53]198 of former professional athletes, however, have suggested the potential for cumulative concussive and subconcussive impacts over an athlete's playing career to be associated with late-life cognitive impairment, depression, and chronic traumatic encephalopathy.…”

mentioning

confidence: 96%

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Broglio

Cantu

Gioia

et al. 2014

Journal of Athletic Training

Self Cite

712

621

View full text Add to dashboard Cite

Objective:To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions.Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations:The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.

show abstract

mentioning

confidence: 96%

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Broglio

Cantu

Gioia

et al. 2014

Journal of Athletic Training

Self Cite

712

621

View full text Add to dashboard Cite

show abstract

“…28 The Sensory Organization Test (SOT; NeuroCom Smart Balance Master; NeuroCom International Inc, Clackamas, OR), which is not a traditional biomechanical assessment, uses aspects of biomechanical techniques through a force-plate-based posturography system that measures center-of-pressure (COP) movements while systematically manipulating visual, somatosensory, and vestibular information. Clinically, the SOT has been shown to be sensitive to functional deficiencies in the visual, vestibular, and somatosensory systems often seen after concussion or mTBI 29,30 and, in turn, has been used to track recovery from concussion and evaluate the effectiveness of rehabilitation. 31,32 The primary outcome of the SOT is the equilibrium score.…”

mentioning

confidence: 99%

Using Accelerometer and Gyroscopic Measures to Quantify Postural Stability

Alberts

Hirsch

Koop

et al. 2015

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Force platforms and 3-dimensional motion-capture systems provide an accurate method of quantifying postural stability. Substantial cost, space, time to administer, and need for trained personnel limit widespread use of biomechanical techniques in the assessment of postural stability in clinical or field environments.Objective: To determine whether accelerometer and gyroscope data sampled from a consumer electronics device (iPad2) provide sufficient resolution of center-of-gravity (COG) movements to accurately quantify postural stability in healthy young people.Design: Controlled laboratory study. Setting: Research laboratory in an academic medical center.Patients or Other Participants: A total of 49 healthy individuals (age ¼ 19.5 6 3.1 years, height ¼ 167.7 6 13.2 cm, mass ¼ 68.5 6 17.5 kg).Intervention(s): Participants completed the NeuroCom Sensory Organization Test (SOT) with an iPad2 affixed at the sacral level.Main Outcome Measure(s): Primary outcomes were equilibrium scores from both systems and the time series of the angular displacement of the anteroposterior COG sway during each trial. A Bland-Altman assessment for agreement was used to compare equilibrium scores produced by the NeuroCom and iPad2 devices. Limits of agreement was defined as the mean bias (NeuroCom À iPad) 6 2 standard deviations. Mean absolute percentage error and median difference between the NeuroCom and iPad2 measurements were used to evaluate how closely the real-time COG sway measured by the 2 systems tracked each other.Results: The limits between the 2 devices ranged from À0.58 to 0.58 in SOT condition 1 to À2.98 to 1.38 in SOT condition 5. The largest absolute value of the measurement error within the 95% confidence intervals for all conditions was 2.98. The mean absolute percentage error analysis indicated that the iPad2 tracked NeuroCom COG with an average error ranging from 5.87% to 10.42% of the NeuroCom measurement across SOT conditions.Conclusions: The iPad2 hardware provided data of sufficient precision and accuracy to quantify postural stability. Accuracy, portability, and affordability make using the iPad2 a reasonable approach for assessing postural stability in clinical and field environments.Key Words: concussions, motor function, motor control, biomechanics Key PointsThe accelerometer and gyroscope within the iPad2 provided data of sufficient quantity and quality to enable accurate evaluation of postural stability. The accuracy, portability, availability, and affordability of mobile devices can enable health care providers in various clinical and field settings to evaluate postural stability in athletes. To improve clinical outcomes, mobile devices can be a mechanism by which sophisticated biomechanical algorithms are translated to the broader field of athletic trainers and clinical teams treating patients with concussions. The accuracy and reliability of mobile devices must be validated before these systems are used to assess cognitive or motor function.

show abstract

“…Sport-and recreation-related concussions are a growing medical concern, with annual injury estimates increasing from 300,000 (Thurman et al, 1998) a decade ago, to nearly 4 million (Langlois et al, 2006) today. While many of the acute effects of concussion have been well defined , there is now a growing concern over how concussions may affect long-term cognitive functioning (Guskiewicz et al, 2005(Guskiewicz et al, ,2007aMcKee et al, 2009McKee et al, ,2010Omalu et al, 2005Omalu et al, ,2006, motor control (Martini et al, 2011;Sosnoff et al, 2011), and mental health (Broshek and Freeman, 2005). More recently, there has also been speculation that sub-concussive impacts to the head, that is, impacts not resulting in clinically-identifiable concussion, may also adversely affect cerebral function (Gavett et al, 2011;McKee et al, 2009).…”

mentioning

confidence: 99%

Cumulative Head Impact Burden in High School Football

Broglio

Eckner

Martini

et al. 2011

Journal of Neurotrauma

Self Cite

193

182

View full text Add to dashboard Cite

Impacts to the head are common in collision sports such as football. Emerging research has begun to elucidate concussion tolerance levels, but sub-concussive impacts that do not result in clinical signs or symptoms of concussion are much more common, and are speculated to lead to alterations in cerebral structure and function later in life. We investigated the cumulative number of head impacts and their associated acceleration burden in 95 high school football players across four seasons of play using the Head Impact Telemetry System (HITS). The 4-year investigation resulted in 101,994 impacts collected across 190 practice sessions and 50 games. The number of impacts per 14-week season varied by playing position and starting status, with the average player sustaining 652 impacts. Linemen sustained the highest number of impacts per season (868); followed by tight ends, running backs, and linebackers (619); then quarterbacks (467); and receivers, cornerbacks, and safeties (372). Post-impact accelerations of the head also varied by playing position and starting status, with a seasonal linear acceleration burden of 16,746.1g, while the rotational acceleration and HIT severity profile burdens were 1,090,697.7 rad/sec 2 and 10,021, respectively. The adolescent athletes in this study clearly sustained a large number of impacts to the head, with an impressive associated acceleration burden as a direct result of football participation. These findings raise concern about the relationship between sub-concussive head impacts incurred during football participation and late-life cerebral pathogenesis, and justify consideration of ways to best minimize impacts and mitigate cognitive declines.

show abstract

Previous Mild Traumatic Brain Injury and Postural-Control Dynamics

Abstract: Individuals with a history of mTBI exhibited altered postural dynamics compared with individuals without a history of mTBI. These findings support the notion that changes in cerebral functioning that affect postural control may persist long after acute injury resolution.

Cited by 130 publications

References 32 publications

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

National Athletic Trainers' Association Position Statement: Management of Sport Concussion

Using Accelerometer and Gyroscopic Measures to Quantify Postural Stability

Cumulative Head Impact Burden in High School Football

Contact Info

Product

Resources

About