Abstract
Balance assessment is an integral component of concussion evaluation and management. Although the modified balance error scoring system (mBESS) is the conventional clinical tool, objective metrics derived from wearable inertial sensors during the mBESS may increase sensitivity in detecting subtle balance deficits post-concussion. The aim of this study was to identify which stance condition and postural sway metrics obtained from an inertial sensor placed on the lumbar spine during the mBESS best discriminate athletes with acute concussion. Fifty-two college athletes in the acute phase of concussion and seventy-six controls participated in this study. Inertial sensor-based measures objectively detected group differences in the acutely concussed group of athletes while the clinical mBESS did not (p < 0.001 and p = 0.06, respectively). Mediolateral postural sway during the simplest condition of the mBESS (double stance) best classified those with acute concussion. Inertial sensors provided a sensitive and objective measure of balance in acute concussion. These results may be developed into practical guidelines to improve and simplify postural sway analysis post-concussion.
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Abbreviations
- NCAA:
-
National Collegiate Athletic Association
- BESS:
-
Balance error scoring system
- mBESS:
-
Modified BESS
- DS:
-
Double stance
- TS:
-
Tandem stance
- SLS:
-
Single limb stance
- SCAT-3:
-
Sport concussion assessment tool 3
- PCS:
-
Post-concussive syndrome
- BMI:
-
Body mass index
- AUC:
-
Area under the receiver operating characteristic curve
- AP:
-
Anteroposterior
- ML:
-
Mediolateral
- SOT:
-
Sensory organization test
- COP:
-
Center of pressure
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Acknowledgments
This project was supported by the Oregon Clinical and Translational Research Institute (KL2TR000152) from the National Center for Advancing Translational Sciences at the National Institutes of Health (NIH); (UL1TR000128) and Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH under Award Number (R21HD080398). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The authors would like to thank all of the participating universities and athletic trainers who contributed to recruitment of subjects and athletes for their participation. All inertial sensor data presented in this paper was obtained using APDM wearable technologies. The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation.
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The authors have no conflicts of interest to disclose.
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King, L.A., Mancini, M., Fino, P.C. et al. Sensor-Based Balance Measures Outperform Modified Balance Error Scoring System in Identifying Acute Concussion. Ann Biomed Eng 45, 2135–2145 (2017). https://doi.org/10.1007/s10439-017-1856-y
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DOI: https://doi.org/10.1007/s10439-017-1856-y