A preliminary cross-sectional assessment of postural control responses to continuous platform rotations following a sport-related concussion

Gait Posture. 2020 Sep:81:213-217. doi: 10.1016/j.gaitpost.2020.08.105. Epub 2020 Aug 8.

Abstract

Background: Individuals suffering a sport-related concussion typically recover within 1 month; however, persistent post-concussive symptoms are known to occur beyond this period. Clinical guidelines may not be sufficient to determine if dynamic postural control is still impaired at the point of the return to play decision.

Research question: Do individuals with a previous sport-related concussion who have returned to play show differences in postural control compared to individuals without a previous concussion, in response to continuous platform perturbations?

Methods: Eight previously concussed and eight age- and position-matched participants completed six one-minute trials (three with eyes open/closed) whilst stood on a moving platform that rotated about the pitch axis with a peak-to-peak amplitude of 4° at a frequency of 0.8 Hz. Six trials were also captured during static quiet stance for comparison. Reactive and anticipatory stages of postural control were analysed by determining anteroposterior margins of stability (MoS) as a measure of whole-body postural control and head-to-trunk anchoring index as an indication of the head-trunk segmental coupling strategy.

Results: Posterior MoS during platform rotations reduced for both groups during eyes closed trials, but previously concussed participants exhibited a significantly greater reduction (1.97 cm) in comparison to matched-controls (0.34 cm). Participants, regardless of group, showed a preference towards a head-stabilised-to-trunk strategy during platform rotations. There were no differences during static trials.

Significance: This preliminary study suggests previously concussed athletes demonstrate a greater reduction in postural control whilst undergoing continuous platform rotations with eyes closed, which could indicate possible lingering deficits to other sensory systems such as the vestibular system, though participants were not likely to lose their balance.

Keywords: Anchoring index; Margins of stability; Postural control; Return to play; Sport concussion.

MeSH terms

  • Adult
  • Athletic Injuries / diagnosis*
  • Brain Concussion / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Postural Balance / physiology*
  • Young Adult