Background

Individuals suffering a sport-related concussion typically recover within 1 month; however, persistent post-concussive symptoms are known to occur beyond this period. Clinical guidelines may not be sufficient to determine if dynamic postural control is still impaired at the point of the return to play decision.

Research question

Do individuals with a previous sport-related concussion who have returned to play show differences in postural control compared to individuals without a previous concussion, in response to continuous platform perturbations?

Methods

Eight previously concussed and eight age- and position-matched participants completed six one-minute trials (three with eyes open/closed) whilst stood on a moving platform that rotated about the pitch axis with a peak-to-peak amplitude of 4° at a frequency of 0.8 Hz. Six trials were also captured during static quiet stance for comparison. Reactive and anticipatory stages of postural control were analysed by determining anteroposterior margins of stability (MoS) as a measure of whole-body postural control and head-to-trunk anchoring index as an indication of the head-trunk segmental coupling strategy.

Results

Posterior MoS during platform rotations reduced for both groups during eyes closed trials, but previously concussed participants exhibited a significantly greater reduction (1.97 cm) in comparison to matched-controls (0.34 cm). Participants, regardless of group, showed a preference towards a head-stabilised-to-trunk strategy during platform rotations. There were no differences during static trials.

Significance

This preliminary study suggests previously concussed athletes demonstrate a greater reduction in postural control whilst undergoing continuous platform rotations with eyes closed, which could indicate possible lingering deficits to other sensory systems such as the vestibular system, though participants were not likely to lose their balance.

中文翻译：

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运动相关脑震荡后姿势控制对平台连续旋转的响应的初步横截面评估。

背景

患有运动相关脑震荡的个体通常在1个月内康复；但是，已知持续性脑震荡后的症状会在此期间之外发生。临床指南可能不足以确定在恢复比赛决策时动态姿势控制是否仍然受到损害。

研究问题

与先前没有脑震荡的人相比，先前曾与运动相关的脑震荡重返比赛的人是否表现出对姿势的控制上的差异，以应对持续的平台扰动？

方法

八名先前受到冲击的患者和八名年龄和体位匹配的参与者完成了六个一分钟的试验（三个睁开/闭着眼睛），同时站在一个移动平台上，该平台绕俯仰轴旋转，峰峰值幅度为4°，频率为0.8 Hz。在静静姿态下还进行了六项试验，以进行比较。通过确定前后稳定性（MoS）作为整体姿势控制的量度，并通过头-头锚固指数作为头-头节段耦合策略的指标，分析姿势控制的反应性和预期阶段。

结果

闭眼试验期间，两组患者平台旋转时的后部MoS均降低，但与对照组相比（0.34 cm），先前发生脑震荡的受试者的MoS降低幅度更大（1.97 cm）。参与者（不分小组）在平台轮换期间都表现出偏向于头枕稳定的策略。静态试验期间没有差异。

意义

这项初步研究表明，先前受过脑震荡的运动员表现出姿势控制的更大降低，同时闭眼不停地进行连续平台旋转，这可能表明其他感觉系统（如前庭系统）可能存在挥之不去的缺陷，尽管参与者不太可能失去平衡。