Thirty-Second Single-Leg Stance Identifies Impaired Postural Control in Children After Concussion: A Preliminary Report

in Journal of Sport Rehabilitation
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Context: Objective and expedient assessments of standing postural control incorporating static and dynamic tasks are necessary for identifying subtle motor deficits and clearing children to return to high-risk activities after concussion. The Revised Physical and Neurological Examination for Subtle Signs (PANESS) gaits and stations tasks evaluate both static and dynamic aspects of postural control. While the PANESS gaits and stations subscale is sensitive to concussion in youth, the benefit of each specific task for this purpose is unknown. Purpose: This study evaluated whether specific PANESS tasks identify postural impairments after youth concussion. Design: Cross-sectional study. Setting: Academicallyaffiliated research laboratory. Participants: Sixty youth, ages 10–17 years, comprised 3 groups: (1) youth symptomatic from concussion (4–14 d postinjury [n = 18]), (2) clinically-recovered youth (27–122 d postinjury [n = 15]), and (3) age- and gender-matched never-concussed controls (n = 27). Main Outcome Measure: PANESS gaits and stations tasks (6 dynamic and 3 static) at the time of the initial research visit. Results: Kruskal–Wallis statistic identified a significant main effect of group on standing on one foot (a 30-s task). Both symptomatic and clinically-recovered youth showed deficits on standing on one foot relative to controls. Conclusions: Single-leg tasks of longer duration may maximize the ability to detect residual postural deficits after concussion and can be readily incorporated in targeted sport rehabilitation protocols.

Saleem is with the Department of Rehabilitation Science, The State University of New York at Buffalo, Buffalo, NY, USA. Slomine and Suskauer are with the Kennedy Krieger Institute, Baltimore, MD, USA; and the Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Slomine is also with the Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. Suskauer is also with the Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Saleem (ghazalas@buffalo.edu) is corresponding author.
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