Eric D. Merritt and Julianne D. Schmidt
Eric D. Merritt, Cathleen N. Brown, Robin M. Queen, Kathy J. Simpson and Julianne D. Schmidt
Dynamic balance deficits exist following a concussion, sometimes years after injury. However, clinicians lack practical tools for assessing dynamic balance.
To determine if there are significant differences in static and dynamic balance performance between individuals with and without a history of concussion.
Clinical research laboratory.
Patients or Other Participants:
45 collegiate student-athletes with a history of concussion (23 males, 22 females; age = 20.0 ± 1.4 y; height = 175.8 ± 11.6 cm; mass = 76.4 ± 19.2 kg) and 45 matched controls with no history of concussion (23 males, 22 females; age = 20.0 ± 1.3 y; height = 178.8 ± 13.2 cm; mass = 75.7 ± 18.2 kg).
Participants completed a static (Balance Error Scoring System) and dynamic (Y Balance Test-Lower Quarter) balance assessment.
Main Outcome Measures:
A composite score was calculated from the mean normalized Y Balance Test-Lower Quarter reach distances. Firm, foam, and overall errors were counted during the Balance Error Scoring System by a single reliable rater. One-way ANOVAs were used to compare balance performance between groups. Pearson’s correlations were performed to determine the relationship between the time since the most recent concussion and balance performance. A Bonferonni adjusted a priori α < 0.025 was used for all analyses.
Static and dynamic balance performance did not significantly differ between groups. No significant correlation was found between the time since the most recent concussion and balance performance.
Collegiate athletes with a history of concussion do not present with static or dynamic balance deficits when measured using clinical assessments. More research is needed to determine whether the Y Balance Test-Lower Quarter is sensitive to acute balance deficits following concussion.
Nicole L. Hoffman, Hannes Devos and Julianne D. Schmidt
Driving performance prior to concussion is not commonly available to help clinicians identify when deficits return to a preinjury status. This case report examines driving performance prior to and following concussion in a 20-year-old male college student. He initially volunteered as a control for a separate driving performance study. He sustained a concussion 18 months later, and was asked to complete the same driving tasks as previous testing once he was asymptomatic. Poor driving simulator performance and subtle cognitive deficits in complex attention and processing speed were evident despite being symptom-free. Our findings may be useful when considering readiness to drive postconcussion.
J.D. DeFreese, Michael J. Baum, Julianne D. Schmidt, Benjamin M. Goerger, Nikki Barczak, Kevin M. Guskiewicz and Jason P. Mihalik
Context: Concussion baseline testing helps injury evaluation by allowing postinjury comparisons to preinjury measures. To facilitate best practice, common neurocognitive, balance, and symptom report metrics used in concussion baseline testing merit examination relative to participant life stressors. Objective: The purpose of this study was to determine if life stressors are associated with college athlete neurocognitive function, postural control, and symptom scores at preseason baseline assessment. Design: All study variables were collected in a single laboratory session where athletes completed valid and reliable psychometrics as well as a computerized neurocognitive and balance assessments. Setting: Sports medicine research center on an American university campus. Participants: A convenience sample of 123 college student-athletes: 47 females (age = 18.9 [4.3] y) and 76 males (age = 19.4 [1.6] y). Main Outcome Measures: Participants were categorized into low, moderate, or high life stressors groups using scores from the Social Readjustment Rating Scale-Revised. Dependent variables included outcomes from the CNS Vitals Signs test, the Sensory Organization Test, and the graded symptom checklist indexing neurocognition, balance, and symptom severity, respectfully. Results: One-way analysis of variance revealed that the moderate life stressors group performed significantly worse than the low life stressors group on the baseline verbal memory domain of the CNS Vital Signs (F 2,119 = 3.28; P = .04) only. Conclusion: In the current college athlete sample, few baseline concussion assessment variables were found to be significantly associated with life stressors. Considering the clinical significance of these variables, psychological life stressors may not be a confounding factor in concussion evaluation.