Residual Effects of Concussions on Stability in Male Collegiate Athletes

Background/Purpose: The frequency of sport related concussions has dramatically increased over the last 15 years. With an estimated 50,000 to 300,000 new cases occurring every year in the United States, concussions are now considered a major public health concern. Concussions account for 80-90% of all major traumatic brain injuries and can have a negative effect on cerebral functioning for days, weeks or longer. Concussions have lingering effects on postural control for 3-4 days, even among athletes with no signs of functional stability issues. Initial acute balance deficits are predictive of post-concussion symptoms at three months, stressing the importance of balance assessment in the acute phase of symptoms and at three months post injury. The purpose of this study was to determine if athletes suffer from post-concussion instability after all other symptoms have subsided.

Method: : Thirty-two male Division III collegiate athletes, fifteen with concussions in the past eighteen months and eighteen without (age: 19.09 ± 1.51yrs; ht.: 185.64 ± 10.84 cm; wt.: 95.25 ± 20.43 kg; sport experience: 13.50 ±3.88 yrs.) participated in the study. Subjects completed the Balance Error Scoring System (BESS) test holding double-leg, single-leg, and tandem stances on a firm surface and on a foam balance pad. Stances were held for twenty seconds with eyes closed and hands on hips. All tests were performed barefoot. A two sample t-test run in Minitab 16 was used to determine if there was a significant difference in non-concussed (NC) versus concussed (C) athletes’ BESS scores.

Analysis/Results: The NC athletes scored slightly higher (47.8 out of 60) than the C group (46.6 out of 60). There was no significant difference (p= 0.534, p > 0.05) between the two groups.

Conclusions: No significant difference was found between the NC group BESS scores and the C group scores, but a difference between the two groups was seen in quality of movements during balance errors. Those with previous concussions were observed to have greater postural sway, especially when standing on the foam pad. Future research should examine concussed individuals closer in time to their last concussion and increase the number of participants as well as quantifying difference in postural sway seen in the two groups. This research could help determine the long lasting effects of concussions and help create appropriate timetables for athletes to safely return to high intensity exercise.