Article Text

Download PDFPDF
The feasibility of romberg quotient in assessment of balance after sport concussion
  1. Matti Vartiainen1,
  2. Anu Holm2,
  3. Sanna Koskinen1,
  4. Laura Hokkanen1
  1. 1University of Helsinki, Institute of Behavioural Sciences, Division of Cognitive Psychology and Neuropsychology, Helsinki, Finland
  2. 2Department of Clinical Neurophysiology, Satakunta Central Hospital, Pori, Finland


Objective To evaluate the feasibility of a computerised balance test and a calculated Romberg Quotient in acute recognition of concussion

Design Prospective pilot study.

Setting Finnish national ice hockey league.

Participants Four teams participated in the study (n=113, male). Nine athletes who sustained a head/neck-related injury and control group of seven non-concussed volunteer players were followed.

Study procedure All participants underwent the baseline assessment before season. The study period was one hockey season 2009- 2010. All game related concussions during this time were recorded. Post-concussion assessment was administered within 36 hours after injury.

Outcome measures Balance was measured using a portable computerised platform. Romberg test stances were used on hard surface and soft foam. The participants stood still for 30 seconds with a closed stance. A relative balance change, Romberg Quotient (RQ), was assessed by calculating the ratio between eyes open, and eyes closed parameters. RQ was computed for sway length, area and velocity in each condition

Main results Concussed and control group did not differ in balance measures at baseline. At post-injury, soft foam measures showed a difference between groups in sway length (U=5.0, p=0.005) and velocity (U=5.0, p=0.005). Among the concussed, RQ mean in sway velocity was 2.02 (1.7–2.3, 95% confidence limits) at baseline and 2.14 (1.9–2.4) post-injury

Conclusions Alternating between different visual and/or somatosensory conditions in balance testing brings out the effect of concussions. RQ is easy to calculate regardless of the measurement systems or scales and can be used as valid tool in sport concussion measurement

Competing interests None.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.