The Effect of Sex, Sport Participation, and Concussion History on Baseline Concussion Balance Test Performance in Division-I Collegiate Athletes

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S19.1-S19
Author(s):  
Carolina Quintana ◽  
Nathan Morelli ◽  
Morgan L. Andrews ◽  
Madison Kelly ◽  
Nicholas Heebner ◽  
...  
Keyword(s):  
Test Performance ◽  
Sport Participation ◽  
Postural Sway ◽  
Collegiate Athletes ◽  
Sports Participation ◽  
Division I ◽  
Balance Performance ◽  
Balance Test ◽  
Eyes Closed ◽  
Concussion History

ObjectiveExplore the effect of baseline characteristics such as sex, sport, and concussion history on the Concussion Balance Test (COBALT) performance in collegiate athletes.BackgroundThe COBALT is a recently developed clinical balance assessment specifically for athletic populations following concussion. The task conditions of the COBALT are designed to challenge sensory integration and reweighting processing underlying postural control. It has been documented that balance performance is influenced by factors such as sex and sport in collegiate athletes.Design/MethodsOne-hundred twenty seven collegiate athletes (77 male, 50 female; age: 19.81 ± 1.39; height: 68.77 ± 5.57 in; mass: 80.98 ± 26.15 kg), who participated in Division-I football, soccer, or cheerleading were included. Participants completed the 4 baseline conditions (Condition 3, 4, 7, 8) of the COBALT. Condition 3 (C3) included a side-to-side headshake with eyes closed. For Condition 4 (C4) the participant stood with hands clasped, elbows extended, and thumbs up while rotating their trunk side-to-side, visually focusing on their thumbs. Conditions 7 (C7) and 8 (C8) repeated C3 and C4 on a foam surface. Two 20-second trials of each condition were completed on a forceplate and the mean angular sway velocity (°/s) were calculated and number of errors were counted. ANOVAs and ANCOVAs were used to assess the potential effects on COBALT performance.ResultsThere were no significant differences in postural sway for any COBALT condition based on sex (p > 0.05). Females demonstrated more errors than males on C7 (p < 0.001). Cheerleaders had more balance errors compared to football athletes for C3 and C7 (p < 0.05) and soccer athletes for C7 (p < 0.05). Concussion history did not have an effect on COBALT performance (p > 0.05).ConclusionsUnderstanding factors that may influence COBALT performance at baseline may enhance concussion evaluation in collegiate athletes with suspected balance deficits following concussion. While concussion history had no effect, sex and sports participation may influence performance and should be considered when interpreting COBALT results post-concussion.

Star Excursion Balance Test Performance Varies by Sport in Healthy Division I Collegiate Athletes

2015 ◽  
Vol 45 (10) ◽  
pp. 772-780 ◽  
Author(s):  
Mikel R. Stiffler ◽  
Jennifer L. Sanfilippo ◽  
M. Alison Brooks ◽  
Bryan C. Heiderscheit
Keyword(s):  
Test Performance ◽  
Collegiate Athletes ◽  
Division I ◽  
Balance Test ◽  
Star Excursion Balance Test

scholarly journals Concussion History and Balance Performance in Adolescent Rugby Union Players

2021 ◽  
pp. 036354652199870
Author(s):  
Mark Matthews ◽  
William Johnston ◽  
Chris M. Bleakley ◽  
Richard J. Davies ◽  
Alan T. Rankin ◽  
...  
Keyword(s):  
Dual Task ◽  
Inertial Sensor ◽  
Dynamic Balance ◽  
Rugby Union ◽  
Static Balance ◽  
Balance Performance ◽  
Eyes Closed ◽  
History Of ◽  
Concussion History ◽  
Rugby Players

Background: Sports-related concussion is a worldwide problem. There is a concern that an initial concussion can cause prolonged subclinical disturbances to sensorimotor function that increase the risk of subsequent injury. The primary aim of this study was to examine whether a history of sports-related concussion has effects on static and dynamic balance performance in adolescent rugby players. Hypothesis: Dynamic balance would be worse in players with a history of concussion compared with those with no history of concussion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male adolescent rugby players aged 14 to 18 years from 5 schools were recruited before the start of the 2018-2019 playing season. Participants completed questionnaires and physical tests, including dynamic Y balance and single-leg static balance (eyes closed) tests, while performing single and dual tasks. Dynamic balance was assessed using inertial sensor instrumentation. Dependent variables were normalized reach distance and the sample entropy (SEn) of the 3 axes ( x, y, and z). Results: Of the 195 participants, 100 reported a history of concussion. Those with a history of concussion demonstrated higher SEn in all directions, with highest values during anterior (standardized mean difference [SMD], 0.4; 95% CI, 0.0-0.7; P = .027) and posteromedial (SMD, 0.5; 95% CI, 0.2-0.9; P = .004) reach directions compared with those with no history. There was no difference between groups (concussion history vs control) in traditional Y balance reach distances in the anterior or posteromedial directions or single-leg static balance during both single- ( P = .47) and dual-task ( P = .67) conditions. Conclusion: Adolescent rugby union athletes with a history of concussion had poorer dynamic balance during performance tasks compared with healthy controls. Static single-leg balance tests, either single or dual task, may not be sensitive enough to detect sensorimotor deficits in those with a history of concussion.

scholarly journals Differences in Responses on the Modified Clinical Test of Sensory Interaction and Balance on Medium Firm and Medium Density Foam in Healthy Controls and Patients with Vestibular Disorders

2020 ◽  
Vol 5 (1) ◽  
pp. 1-8
Author(s):  
Helen S. Cohen ◽  
Haleh Sangi-Haghpeykar
Keyword(s):  
Test Performance ◽  
Clinical Decision Making ◽  
Head Movements ◽  
Clinical Test ◽  
Medium Density ◽  
Foam Density ◽  
Vestibular Disorders ◽  
Trial Duration ◽  
Balance Test ◽  
Eyes Closed

Purpose: To determine whether foam density affects modified Romberg balance test performance. Materials and Methods: Controls and patients with vestibular disorders performed Romberg tests on medium and medium firm foam, with their eyes closed and the head still and moving in yaw and pitch. The trial duration and number of head movements were measured. Results: Subjects aged >60 years performed longer and with more head movements on medium firm foam than on medium foam. Older controls did not differ between medium firm and medium foam. Older patients had higher scores on head-still and head-yaw trials on medium firm foam versus medium foam but pitch trials did not differ. Females, controls, and patients had longer trial durations and more head movements on medium firm foam than on medium density foam; male controls did not differ by foam density. Male patients differed in yaw trials. Conclusion: Foam density affects scores. Clinical decision-making may be adversely affected if the clinician uses foam of a density that is not the same as that of the foam that was used in the studies that developed descriptive statistics, sensitivity, and specificity.

scholarly journals Sport-specific differences in dynamic visual acuity and gaze stabilization in division-I collegiate athletes

2020 ◽  
Vol 30 (4) ◽  
pp. 249-257
Author(s):  
C. Quintana ◽  
N.R. Heebner ◽  
A.D. Olson ◽  
J.P. Abt ◽  
M.C. Hoch
Keyword(s):  
Visual Acuity ◽  
A Priori ◽  
Collegiate Athletes ◽  
Division I ◽  
Normative Values ◽  
Dynamic Visual Acuity ◽  
Gaze Stabilization ◽  
Concussion Management ◽  
Vestibular Ocular Reflex ◽  
Concussion History

BACKGROUND: The vestibular-ocular reflex (VOR) integrates the vestibular and ocular systems to maintain gaze during head motion. This reflex is often negatively affected following sport-related concussion. Objective measures of gaze stability, a function mediated by the VOR, such as the computerized dynamic visual acuity test (DVAT) and gaze stabilization test (GST), may have utility in concussion management. However, normative data specific to sport, sex, or concussion history have not been established in collegiate athletes. OBJECTIVE: The objective of this study was to establish normative values for the DVAT and GST in collegiate athletes and explore the effect of sport, sex, and concussion history on VOR assessments. METHODS: The DVAT and GST were completed by 124 collegiate athletes (72 male, 52 female, mean±SD, age: 19.71±1.74 years, height: 173.99±13.97 cm, weight: 80.06±26.52 kg) recruited from Division-I athletic teams (football, soccer and cheerleading). The DVAT and GST were performed in the rightward and leftward directions during a single session in a standardized environment. Normative values for DVAT and GST measures were expressed as percentiles. Non-parametric statistics were used to compare differences between groups based on sex, sport, and concussion history. Alpha was set a-priori at 0.05. RESULTS: Overall, the median LogMAR unit for 124 athletes completing the DVAT was 0 (IQR = 0.17) for both leftward and rightward. The median velocities achieved on the GST were 145 °/sec and 150 °/sec (IQR = 45 and 40) for the leftward and rightward directions respectively. Significant differences were observed between sports (p = 0.001–0.17) for the GST with cheerleading demonstrating higher velocities than the other sports. However, no significant differences were identified based on sex (p≥0.09) or history of concussion (p≥0.15). CONCLUSIONS: Normative estimates for the DVAT and GST may assist in the clinical interpretation of outcomes when used in post-concussion evaluation for collegiate athletes. Although sex and previous concussion history had no effect on the DVAT or GST, performance on these measures may be influenced by type of sport. Sport-related differences in the GST may reflect VOR adaptations based on individual sport-specific demands.

Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis

2011 ◽  
Vol 45 (8) ◽  
pp. 660-672 ◽  
Author(s):  
Claire E Hiller ◽  
Elizabeth J Nightingale ◽  
Chung-Wei Christine Lin ◽  
Garrett F Coughlan ◽  
Brian Caulfield ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ankle Sprain ◽  
Test Performance ◽  
Postural Sway ◽  
Meta Analysis ◽  
Position Sense ◽  
Joint Position Sense ◽  
Ankle Sprains ◽  
Eyes Closed ◽  
Recurrent Ankle Sprain

ObjectiveTo examine whether people with recurrent ankle sprain, have specific physical and sensorimotor deficits.DesignA systematic review of journal articles in English using electronic databases to September 2009. Included articles compared physical or sensorimotor measures in people with recurrent (≥2) ankle sprains and uninjured controls.Main outcome groupsOutcome measures were grouped into: physical characteristics, strength, postural stability, proprioception, response to perturbation, biomechanics and functional tests. A meta-analysis was undertaken where comparable results within an outcome group were inconsistent.ResultsFifty-five articles met the inclusion criteria. Compared with healthy controls, people with recurrent sprains demonstrated radiographic changes in the talus, changes in foot position during gait and prolonged time to stabilisation after a jump. There were no differences in ankle range of motion or functional test performance. Pooled results showed greater postural sway when standing with eyes closed (SMD=0.9, 95% CI 0.4 to 1.4) or on unstable surfaces (0.5, 0.1 to 1.0) and decreased concentric inversion strength (1.1, 0.2 to 2.1) but no difference in evertor strength, inversion joint position sense or peroneal latency in response to a perturbation.ConclusionThere are specific impairments in people with recurrent ankle sprain but not necessarily in areas commonly investigated.

scholarly journals Multivariate Analyses of Balance Test Performance, Vestibular Thresholds, and Age

2017 ◽  
Vol 8 ◽  
Author(s):  
Faisal Karmali ◽  
María Carolina Bermúdez Rey ◽  
Torin K. Clark ◽  
Wei Wang ◽  
Daniel M. Merfeld
Keyword(s):  
Test Performance ◽  
Principal Component ◽  
Vertical Axis ◽  
Balance Test ◽  
Healthy Humans ◽  
Eyes Closed ◽  
Multiple Variable ◽  
Variation Explained ◽  
Romberg Test ◽  
Roll Tilt

We previously published vestibular perceptual thresholds and performance in the Modified Romberg Test of Standing Balance in 105 healthy humans ranging from ages 18 to 80 (1). Self-motion thresholds in the dark included roll tilt about an earth-horizontal axis at 0.2 and 1 Hz, yaw rotation about an earth-vertical axis at 1 Hz, y-translation (interaural/lateral) at 1 Hz, and z-translation (vertical) at 1 Hz. In this study, we focus on multiple variable analyses not reported in the earlier study. Specifically, we investigate correlations (1) among the five thresholds measured and (2) between thresholds, age, and the chance of failing condition 4 of the balance test, which increases vestibular reliance by having subjects stand on foam with eyes closed. We found moderate correlations (0.30–0.51) between vestibular thresholds for different motions, both before and after using our published aging regression to remove age effects. We found that lower or higher thresholds across all threshold measures are an individual trait that account for about 60% of the variation in the population. This can be further distributed into two components with about 20% of the variation explained by aging and 40% of variation explained by a single principal component that includes similar contributions from all threshold measures. When only roll tilt 0.2 Hz thresholds and age were analyzed together, we found that the chance of failing condition 4 depends significantly on both (p = 0.006 and p = 0.013, respectively). An analysis incorporating more variables found that the chance of failing condition 4 depended significantly only on roll tilt 0.2 Hz thresholds (p = 0.046) and not age (p = 0.10), sex nor any of the other four threshold measures, suggesting that some of the age effect might be captured by the fact that vestibular thresholds increase with age. For example, at 60 years of age, the chance of failing is roughly 5% for the lowest roll tilt thresholds in our population, but this increases to 80% for the highest roll tilt thresholds. These findings demonstrate the importance of roll tilt vestibular cues for balance, even in individuals reporting no vestibular symptoms and with no evidence of vestibular dysfunction.

The Influence of Cognitive Dual Tasks on Concussion Balance Test Performance

Motor Control ◽  
2020 ◽  
pp. 1-12
Author(s):  
Nathan Morelli ◽  
Nicholas R. Heebner ◽  
Courtney J. DeFeo ◽  
Matthew C. Hoch
Keyword(s):  
Dual Task ◽  
Test Performance ◽  
Sensory Integration ◽  
Postural Sway ◽  
Clinical Tool ◽  
Dual Tasks ◽  
Balance Test ◽  
Concussion Recovery ◽  
Task Conditions ◽  
Head Rotations

Objective: To determine the influence of a cognitive dual task on postural sway and balance errors during the Concussion Balance Test (COBALT). Methods: Twenty healthy adults (12 females, eight males; aged 21.95 ± 3.77 years; height = 169.95 ± 9.95 cm; weight = 69.58 ± 15.03 kg) partook in this study and completed single- and dual-task versions of a reduced COBALT. Results: Sway velocity decreased during dual-task head rotations on foam condition (p = .021, ES = −0.57). A greater number of movement errors occurred during dual-task head rotations on firm surface (p = .005, ES = 0.71), visual field flow on firm surface (p = .008, ES = 0.68), and head rotations on foam surface (p < .001, ES = 1.61) compared with single-task conditions. Cognitive performance was preserved throughout different sensory conditions of the COBALT (p = .985). Discussion: Cognitive dual tasks influenced postural control and destabilized movements during conditions requiring advanced sensory integration and reweighting demands. Dual-task versions of the COBALT should be explored as a clinical tool to identify residual deficits past the acute stages of concussion recovery.

Investigating Female Athletes’ Balance Using Center-of-Pressure (COP) Derived Displacement and Velocity Parameters

2017 ◽  
Author(s):  
Mehdi Badache ◽  
Lonika Behera ◽  
Nian Zhang ◽  
Lara A. Thompson
Keyword(s):  
Visual Cues ◽  
Female Athletes ◽  
Center Of Pressure ◽  
Collegiate Athletes ◽  
Difficulty Level ◽  
Balance Performance ◽  
Eyes Closed ◽  
Athletic Activities ◽  
Eyes Open ◽  
Track Athletes

A realization of how specific exercises relate to balance performance is important for a wide demographic of individuals. Maintaining active and healthy living is particularly important for balance-impaired individuals (e.g., otherwise healthy individuals recovering from injury, fall-prone elderly, and stroke survivors) whom are interested in improving their balance for function in daily life. However, balance performance is also important for persons that are unimpaired (e.g., athletes). How balance performance may be improved as a result of, and in relation to, various athletic activities and exercises is a common question. Further, how certain activities can be used to prevent injury is an ultimate goal. Our objective was to compare standing balance in 3 unimpaired groups (i.e., female track & female tennis collegiate athletes and female non-athletes). To assess static balance, participants performed stance variations increasing in difficulty-level, utilizing a wide or tandem stance (increasing or decreasing support base) and eyes-open or eyes-closed (limiting or providing visual cues), while standing on a forceplate walkway. Through the recorded ground reaction forceplate-based, center-of-pressure (COP) position time series, we extracted velocity and displacement parameters that aided in identifying differences between the above groups. Our general findings were that anterior-posterior (AP, or front-to-back) COP displacement and velocity measures for female track athletes were unchanged relative to the (baseline) female non-athletes. However, mediolateral (ML, or side-to-side) measures, which have previously been shown to be associated with fall-risk, showed observable differences in displacement and velocity parameters, particularly for the female track athletes. Specifically, the female track athletes were better able to control their ML COP velocity in eyes-closed, wide, and eyes-open tandem conditions compared to non-athletes. However, tennis athletes had difficulty balancing in situations where eyes were closed (vision eliminated) and feet were tandem (base-of-support decreased) which was made apparent by the increases in all AP and ML COP-derived parameters. We interpreted this finding as the female tennis athletes were trained to rely heavily on visual cues (e.g., hand-eye or eye-body coordination), and also their balance may be more focused on maintaining their center-of-mass stability and body orientation, as opposed to COP per se. Our study lends new insights as to how various types of athletic activities, and reliance on vision in athletes, impacts balance performance in un-impaired females.

The effect of combined mechanism ankle support on postural control of patients with chronic ankle instability

2016 ◽  
Vol 41 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Mohammad Hadadi ◽  
Ismaeil Ebrahimi ◽  
Mohammad Ebrahim Mousavi ◽  
Gholamreza Aminian ◽  
Ali Esteki ◽  
...  
Keyword(s):  
Postural Control ◽  
Postural Sway ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Foot And Ankle ◽  
Balance Performance ◽  
Balance Test ◽  
Combined Mechanism ◽  
Ankle Support ◽  
Healthy Participants

Background:Chronic ankle instability is associated with neuromechanical changes and poor postural stability. Despite variety of mechanisms of foot and ankle orthoses, almost none apply comprehensive mechanisms to improve postural control in all subgroups of chronic ankle instability patients.Objectives:The purpose of this study was to investigate the effect of an ankle support implementing combined mechanisms to improve postural control in chronic ankle instability patients.Study design:Cross-sectional study.Methods:An ankle support with combined mechanism was designed based on most effective action mechanisms of foot and ankle orthoses. The effect of this orthosis on postural control was evaluated in 20 participants with chronic ankle instability and 20 matched healthy participants. The single-limb stance balance test was measured in both groups with and without the new orthosis using a force platform.Results:The results showed that application of combined mechanism ankle support significantly improved all postural sway parameters in chronic ankle instability patients. There were no differences in means of investigated parameters with and without the orthosis in the healthy group. No statistically significant differences were found in postural sway between chronic ankle instability patients and healthy participants after applying the combined mechanism ankle support.Conclusion:The combined mechanism ankle support is effective in improving static postural control of chronic ankle instability patients to close to the postural sway of healthy individual. the orthosis had no adverse effects on balance performance of healthy individuals.Clinical relevanceApplication of the combined mechanism ankle support for patients with chronic ankle instability is effective in improving static balance. This may be helpful in reduction of recurrence of ankle sprain although further research about dynamic conditions is needed.

The Relationship Between Hip Strength and the Y Balance Test

2018 ◽  
Vol 27 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Benjamin R. Wilson ◽  
Kaley E. Robertson ◽  
Jeremy M. Burnham ◽  
Michael C. Yonz ◽  
Mary Lloyd Ireland ◽  
...  
Keyword(s):  
Linear Regression ◽  
Test Performance ◽  
External Rotation ◽  
Linear Regression Analysis ◽  
Balance Performance ◽  
Balance Test ◽  
Hip Strength ◽  
Hip Abduction ◽  
The Relationship ◽  
Abduction Strength

Context: The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. However, the relationship between hip strength and performance on the Y Balance Test has not been fully elucidated. Objective: The goal of this study was to identify the relationship between components of isometric hip strength and the Y Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y Balance Test. Design: Laboratory study. Setting: Biomechanics laboratory. Participants: A total of 73 healthy participants (40 males and 33 females) volunteered for this study. Intervention: None. Main Outcome Measures: Participants completed the Y Balance Test on the right leg. The authors then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass and Y Balance Test performance. Significant relationships were used in linear regression models to determine which variables were predictive of the Y Balance Test performance. Results: The authors found significant positive correlations between Y Balance Test performance and hip abduction strength. They also found correlations between the Y Balance Test and hip extension and external rotation strengths. Linear regression analysis showed hip abduction to be the only significant predictor of Y Balance performance. Conclusions: The authors found the strongest association between the Y Balance Test and hip abduction strength. They also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y Balance Test.

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