Context: Altered postural control represents one of the most common motor consequences following a concussion and there is a paucity of data monitoring the recovery trajectory that identifies the persistent changes of postural control. Objective: To determine whether the recovery trajectory of postural control was consistent across different measures of postural stability and whether increased postural challenge (ie, sloped surface) revealed subtle postural impairments. Design: A single-subject case study. Setting: Research laboratory. Patients or Other Participants: One concussed individual with a cohort of healthy controls (n = 10) used for comparison. Main Outcome Measures: Center of pressure variability (linear—SD and nonlinear—multiscale entropy) was used to index postural sway preinjury and at periodic intervals following the concussion. Results: The concussed individuals displayed reduced amounts of sway during the initial recovery phase that failed to returned to preinjury levels but reached the level of healthy controls at 1-month postinjury. The multiscale entropy analysis revealed increased center of pressure irregularity throughout recovery that persisted up to 1-month post injury. Conclusions: The findings identified subtle, persistent postural control impairments revealed through the nonlinear analysis of center of pressure and supports the notion that the consequences of a concussion (ie, impaired postural control) need to be considered beyond the resolution of behavioral symptoms.
Jason D. Stone, Adam C. King, Shiho Goto, John D. Mata, Joseph Hannon, James C. Garrison, James Bothwell, Andrew R. Jagim, Margaret T. Jones, and Jonathan M. Oliver
Purpose: To provide a joint-level analysis of traditional (TS) and cluster (CS) set structure during the back-squat exercise. Methods: Eight men (24  y, 177.3 [7.9] cm, 82.7 [11.0] kg, 11.9 [3.5] % body fat, and 150.3 [23.0] kg 1-repetition maximum [1RM]) performed the back-squat exercise (80%1RM) using TS (4 × 6, 2-min interset rest) and CS (4 × [2 × 3], 30-s intraset rest, 90-s interset rest), randomly. Lower-limb kinematics were collected by motion capture, as well as kinetic data by bilateral force platforms. Results: CS attenuated the loss in mean power (TS −21.6% [3.9%]; CS −12.4% [7.5%]; P = .042), although no differences in gross movement pattern (sagittal-plane joint angles) within and between conditions were observed (P ≥ .05). However, joint power produced at the hip increased from repetition (REP) 1 through REP 6 during TS, while a decrease was noted at the knee. A similar pattern was observed in the CS condition but was limited to the hip. Joint power produced at the hip increased from REP 1 through REP 3 but returned to REP 1 values before a similar increase through REP 6, resulting in differences between conditions (REP 4, P = .018; REP 5, P = .022). Conclusions: Sagittal-plane joint angles did not change in either condition, although CS elicited greater power. Differing joint power contributions (hip and knee) suggest potential central mechanism that may contribute to enhanced power output during CS and warrant further study. Practitioners should consider incorporating CS into training to promote greater power adaptations and to mitigate fatigue.