Publication Date

April 2017


Matthew Kurtz


Neuroscience & Behavior


English (United States)


Background: Sport related concussions are a mounting public health issue. The extensive amount of sport participation from youth to adulthood creates a large population at risk for such an injury. The risk for long term health impacts after sustaining multiple concussions is a cause for concern for the safety and well-being of athletes. In order to minimize risk of multiple concussions, and maximize the health and safety of athletes, clinicians must be able to make informed diagnostic, evaluation, and return to play decisions. Currently, there is a need for reliable and objective sideline tool that can assess postural stability more comprehensively. The Elite Sports Balance Protocol proposes a technique to fill the present gaps in concussion evaluation. Methods: The present study examines the sideline effectiveness of the the Elite Sports Balance Protocol. The protocol consists of a static balance assessment with a cognitive load test component and a dynamic balance assessment. Both assessments were completed on a Wii Balance Board that collected center of pressure data. The static assesment consisted of a total of six balance tests; two stances, single leg and double leg, under three conditions eyes open, eyes closed, and eyes closed with a cognitive load. The dyanmic assessment consisted of participants being shown a computer screen with colored circle targets and were instructed to move their center of pressure (as denoted by a small black dot on the screen) to specific targets. To test sideline effectiveness healthy Wesleyan University varsity student-athletes were put through the protocol both at rest and at fatigue. The order of rest and fatigue trials was determined by random group placement. Results: No significant effect on performance by fatigue was confirmed. Group placement was not significant for the static assessment nor the medial lateral and anterior posterior movements for the dynamic assessment, indicating no learning effect for these portions of the protocol. Gender and concussion history were found to be significant for performance on the dynamic assessment but not the static assessment. Eyes closed with cognitive load test performance compared to eyes closed with no cognitive load test performance was not significant but demonstrated an overall mean trend of improving postural stability for the single and double leg of the rest condition and for the double leg of the fatigue condition, but not the single leg of the fatigue condition. Conclusion: The preliminary finding that fatigue does not effect protocol performance indicates that the Elite Sports Balance Protocol is a good candidate for an effective sideline evaluation technique. Further studies need to be done to examine a possible learning effect over a longer period of time, how gender and concussion history are related to the dynamic assessment performance, and to clarify the effect the cognitive load has on performance for the eyes closed condition.

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