Comparison of dynamic and static postural control in individuals with and without a history of concussions
LE3 .A278 2022
Bachelor of Kinesiology
Introduction: Concussions can result from a direct or indirect force causing the brain to accelerate in the skull, straining brain tissue and altering normal functioning. They are an increasing concern in sport, from detection through treatment and return to play. Concussion recovery should be considered individually specific because there are many signs and symptoms, each requiring protocols in the rehabilitation plan. One concussion related deficit is in postural control, often assessed with a static balance test that may allow athletes to return to sport prematurely. In contrast to static balance tests, this study introduces a sport specific dynamic postural control assessment that measures differences in center of pressure (COP) motion. The strength of neck stabilizers may also help maintain the stability of the neck in contact sport, thus reducing the likelihood of a concussion. Therefore, the purpose of this study was to determine if dynamic balance assessments could detect differences in postural control in individuals with and without a history of concussions and if there was a relationship between neck strength and a history of concussions. Methods: Fifty-one participants (females= 25, males =26) completed this study. Anthropometric measures (reach length, eye height, isometric neck strength, cervical flexion endurance, and dynamic neck strength) were completed. Four novel dynamic balance tests were completed in addition to Balance Error Scoring System (BESS) and Concussion Balance Test (COBALT), giving a comprehensive assessment of postural control, vestibular, ocular, auditory systems, proprioception, and cognition. Results: In contrast with standard clinical practice COP measurements, two of our four novel dynamic tests yielded statistically significant differences based on concussion history and all four measured greater COP mean velocity. A pairwise comparison of these measurements showed statistically significant differences with both BESS and COBALT. All neck strength tests were statistically significant when compared by sex, but not by concussion history. Discussion: The four dynamic sport specific balance tests provide a comprehensive assessment of the functional integration of cognition, postural control, ocular, and auditory systems and allow better understanding of underlying post-concussion postural and cognitive deficits. Neck strength results were sex specific but further research is needed to understand why females are predisposed to concussions. Importance: Dynamic balance assessments are crucial to the long-term success of athletes when returning to play post-concussion. Neck muscles play an important role in head posture and improving their strength, especially in females and may reduce risk of sustaining a concussion.
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