Centre of pressure velocity shows impairments in NCAA Division I athletes six months post-concussion during standing balance

ABSTRACT

Sport-related concussion return to play (RTP) decisions are largely based on the resolution of self-reported symptoms and neurocognitive function. Some evaluators also incorporate balance; however, an objective approach to balance that can detect effects beyond the acute condition is warranted. The purpose of this study is to examine linear measures of biomechanical balance up to 6 months post-concussion, and to present preliminary diagnostic thresholds useful for RTP. Each concussed athlete participated in instrumented standing balance tasks at 4 timepoints post-concussion. The measures from concussed athletes were compared to the sport-matched non-concussed athlete group at each timepoint. Centre of pressure (COP) mediolateral (ML) velocity in double-leg stance on a hard surface discriminated well between non-concussed and concussed athletes. COP anterior-posterior (AP) velocity in tandem stance on foam showed sensitivity to concussion. Sixty per cent of athletes at 6 months post-concussion did not recover to within the proposed COP ML velocity threshold in double-leg stance on a hard surface. Seventy-one per cent of athletes at 6 months post-concussion did not recover to within the COP AP velocity threshold in tandem stance on foam. This lack of recovery potentially indicates vestibular and motor control impairments long past the typical period of RTP.

KEYWORDS:

• Sport-related concussion
• biomechanical balance
• return to play

Acknowledgments

The authors would like to thank the undergraduate student workers in the Human Dynamics Lab for their diligent efforts in collecting and processing this large dataset, the undergraduate and graduate students of the Graduate School of Professional Psychology for developing the RedCAP database, and Anah Gilmore and Rachel Wathan for their assistance with scheduling athlete data collections.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the University of Denver (US) [Pilot Grant].