The effects of mild traumatic brain injury on postural control

Degani, Adriana M.; Santos, Maria M.; Leonard, Charles T.; Rau, Thomas; Patel, Sarjubhai A.; Mohapatra, Sambit; Danna-Dos-Santos, Alessander

doi:10.1080/02699052.2016.1225982

Cited by 35 publications

(42 citation statements)

References 37 publications

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“…In addition, the combination of a portable headmounted display and stability trainers makes this assessment easily accessible in the clinic. SampEn is commonly used in postural control research [33][34][35][36] to study the effect of aging and disease on postural sway regularity. It has been suggested that postural sway tends to become more predictable with any environmental (eg, challenging surface, eyes closed) or personal (eg, older age, disease) restrictions [7].…”

Section: Discussionmentioning

confidence: 99%

Control Mechanisms of Static and Dynamic Balance in Adults With and Without Vestibular Dysfunction in Oculus Virtual Environments

Lubetzky

Hujsak

Kelly

et al. 2018

PM&R

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Background Deficits in sensory integration and fear of falling in complex environments contribute to decreased participation of adults with vestibular disorders. With recent advances in virtual reality technology, head‐mounted displays are affordable and allow manipulation of the environment to test postural responses to visual changes. Objectives To develop an assessment of static and dynamic balance with the Oculus Rift and (1) to assess test‐retest reliability of each scene in adults with and without vestibular hypofunction; (2) to describe changes in directional path and sample entropy in response to changes in visuals and surface and compare between groups; and (3) to evaluate the relation between balance performance and self‐reported disability and balance confidence. Design Test‐retest, blocked‐randomized experimental design. Setting Research laboratory. Participants Twenty‐five adults with vestibular hypofunction and 16 age‐ and sex‐matched adults. Methods Participants stood on the floor or stability trainers while wearing the Oculus Rift. For 3 moving “stars” scenes, they stood naturally. For a “park” scene, they were asked to avoid a virtual ball. The protocol was repeated 1‐4 weeks later. Outcome Anteroposterior and mediolateral center‐of‐pressure directional path and sample entropy were derived from a force plate. Results We observed good to excellent reliability in the 2 groups, with most intraclass correlations above 0.8 and only 2 at approximately 0.4. The vestibular group had higher directional path for the stars scenes and lower directional path for the park scene compared with controls, with large variability in the 2 groups. Sample entropy decreased with more challenging environments. In the vestibular group, less balance confidence strongly correlated with more sway for the stars scenes and less sway for the park scene. Conclusion Virtual reality paradigms can shed light on the control mechanism of static and dynamic postural control. Clinical utility and implementation of our portable Oculus Rift assessment should be further studied. Level of Evidence II

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Section: Discussionmentioning

confidence: 99%

Control Mechanisms of Static and Dynamic Balance in Adults With and Without Vestibular Dysfunction in Oculus Virtual Environments

Lubetzky

Hujsak

Kelly

et al. 2018

PM&R

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“…As a standing balance measure, a force platform (FP4060-05-PT) was used to acquire characteristics of bipedal standing balance test. Following the customized method and procedure described in Degani et al (2017) and Santos et al (2017) [47,48], we asked the subject to stand still on the force plate with barefoot for 120 seconds with crossing their upper limbs against their chest and focusing their vision on a static point at eye level. The task was performed while the subject stood vertically on the top of a force platform while the coordinates of the body's Center of Pressure (CoP) were recorded.…”

Section: Introductionmentioning

confidence: 99%

“…These data were used to compute postural sway based on instantaneous CoP location during the standing task in both anterior-posterior and medio-lateral directions (CoPAP and CoPML, respectively). Adapting Degani et al (2017) and Santos et al (2017) [47,48], the following variables of interest were extracted from CoP coordinates and used in analysis: the area of CoP path (Area), the peak-to-peak amplitude of the CoP displacement in each direction (AmplitudeAP and AmplitudeML), the mean velocity of the CoP displacement in each direction (MVAP and MVML), the frequency at which 80% of the CoP spectral power for each direction (F80AP and F80ML), the sample entropy estimates of the CoP displacement in each direction (SEntAP and SEnt ML), and the cross-sample entropy (CrossSEnt) representing the degree of asynchrony or dissimilarity between CoPAP and CoPML signals in time.…”

Section: Introductionmentioning

confidence: 99%

The Long-Term Impact of Mild Traumatic Brain Injuries on Multiple Functional Outcomes and Epigenetics: A Pilot Study with College Students

Lee¹,

Lee²,

Black³

et al. 2020

Preprint

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People who suffer a mild traumatic brain injury (mTBI) have heterogeneous symptoms and disease trajectories, which make it difficult to precisely diagnose and assess complications long-term. Insufficient information is available regarding how to precisely diagnose and assess mTBI. This study identified and compared deficits in cognitive, psychosocial, visual functions, and balance performance between college students with and without histories of mTBI. Global DNA methylation ratio (5-mC%) in blood was also compared as a peripheral epigenetic marker. Twenty-five volunteers participated in this pilot study, including 11 mTBI cases (27.3% females; mean age of 28.7 years, SD=5.92) and 14 healthy controls (64.3% females; mean age of 22.0, SD=4.13). All the participants were assessed for cognitive (by NIH toolbox—executive function, memory, and processing speed), psychological (by PROMIS—depression, anxiety, and sleep disturbances), visual function (by King-Devick and binocular accommodative tests), postural balance performance (by a force plate), and blood 5-mC% (global methylation) levels. Students with mTBI reported significantly poorer episodic memory, severe anxiety, and more sleep disturbance problems. They also had higher blood 5-mC% level (all p’s<.05). No significant differences were found in visual function and postural balance. These findings validate changes in cognitive, psychosocial, and global DNA methylation long after mTBI.

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“…3 Although CoP measures are limited in clinical settings, they represent an indirect indication of the health of the neurologic system. 10 Furthermore, CoP measures are sensitive to lingering impairments of the postural-control system that may last up to a year after the injury. [11][12][13] However, these lingering postural-control impairments are not typically considered when clinical decisions are made or postconcussion rehabilitation protocols are implemented.…”

mentioning

confidence: 99%

Baseline Postural Control and Lower Extremity Injury Incidence Among Those With a History of Concussion

Murray

Belson

Szekely

et al. 2020

Journal of Athletic Training

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Context Lower extremity musculoskeletal (LEMSK) injury may be more prevalent among those with a history of sport-related concussion (SRC). Objective To investigate the relationship between baseline postural control metrics and the LEMSK injury incidence in National Collegiate Athletic Association Division I student-athletes with a history of SRC. Setting National Collegiate Athletic Association Division I athletes. Design Cohort study. Patients or Other Participants Of 84 total athletes (62 males), 42 had been previously diagnosed with an SRC, and 42 were matched controls based on age, sex, height, weight, and sport. Main Outcome Measure(s) During the preseason baseline evaluation, all participants performed 3 trials of eyes-open and eyes-closed upright quiet stance on a force platform. Medical charts were assessed for all the LEMSK injuries that occurred from preseason baseline to 1 year later. Center-of-pressure data in the anteroposterior and mediolateral directions were filtered before we calculated root mean square and mean excursion velocity; the complexity index was calculated from the unfiltered data. Factorial analysis-of-variance models were used to examine differences between groups and across conditions for root mean square; mean excursion velocity, complexity index, and tests of association to examine between-groups LEMSK differences; and logistic regression models to predict LEMSK. Results Concussion history and injury incidence were related in the SRC group (P = .043). The complexity index of the SRC group was lower with eyes closed (14.08 ± 0.63 versus 15.93 ± 0.52) and eyes open (10.25 ± 0.52 vs 11.80 ± 0.57) in the mediolateral direction than for the control participants (P < .05). Eyes-open root mean square in the mediolateral direction was greater for the SRC group (5.00 ± 0.28 mm) than the control group (4.10 ± 0.22 mm). Logistic regression models significantly predicted LEMSK only in control participants. Conclusions These findings may suggest that LEMSK after SRC cannot be predicted from postural-control metrics at baseline.

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The effects of mild traumatic brain injury on postural control

Abstract: The results suggest that (a) balance deficits can be recognized as an effect of mTBI; (b) balance deficits induced by mTBI are multi-dimensional, affecting all three domains included in this study; and

Cited by 35 publications

References 37 publications

Control Mechanisms of Static and Dynamic Balance in Adults With and Without Vestibular Dysfunction in Oculus Virtual Environments

Control Mechanisms of Static and Dynamic Balance in Adults With and Without Vestibular Dysfunction in Oculus Virtual Environments

The Long-Term Impact of Mild Traumatic Brain Injuries on Multiple Functional Outcomes and Epigenetics: A Pilot Study with College Students

Baseline Postural Control and Lower Extremity Injury Incidence Among Those With a History of Concussion

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