Visual and vestibular involvement in postural deficits following concussion

Abstract

Postural assessment is often recommended as a component of postconcussion examination; however, a reliable, objective approach to identify and monitor the recovery of postural deficits is still needed. Degani et al. (Degani AM, Santos MM, Leonard CT, Rau TF, Patel SA, Mohapatra S, and Danna-Dos-Santos A. Brain Inj 31: 49-56, 2017) suggest that effects of concussion on postural control can be identified at the group level through spatiotemporal, frequency, and dynamic characteristics of balance. In contrast, Wright et al. (Wright WG, Tierney RT, and McDevitt J. J Vestib Res 27: 27-37, 2017) propose additional vestibular and oculomotor assessments to identify processing deficits that impair balance following concussion in individuals.

The use of continuous spectral analysis for the assessment of postural stability changes after sports-related concussion

“…The greatest effect size and the largest frequency range over which a difference was detected was for the increase in AP spectral content in DL stance. Changes were identified across the investigated frequency range, suggesting potential vestibular and cerebellar integration as well as proprioceptive control system effects of SRC, in concordance with existing literature (Christy et al, 2019;Guskiewicz, 2003;Mallinson and Longridge, 1998;Nowak, 2018;Wright et al, 2017). As all trials were performed with vision obscured, for consistency with M-BESS, identification of any post-SRC effects on visual system integration was outside the scope of the study.…”

Contributions of PCSS, BESS, Tandem Gait, and Romberg Test for Identifying Balance Deficits in Pediatric Concussions

“…Balance deficits are common with concussions and may predict longer illness duration in pediatric patients 7,8. Postural balance deficits may result from deficits in either the vestibular/ocular system or the vestibulospinal system 9,10. Vestibular rehabilitation, consisting of vestibular/ocular exercises and balance training, has been shown to reduce dizziness and balance symptoms and improve overall concussion recovery 11,12.…”